Ann Dermatol.  2011 Dec;23(Suppl 3):S290-S295. 10.5021/ad.2011.23.S3.S290.

Dapsone Hypersensitivity Syndrome That Occurred during Treatment of Pediatric Patient with Erythema Elevatum Diutinum

• Kim GW
• Park HJ
• Kim HS
• Kim SH
• Ko HC
• Kim BS
• Kim MB

• KMID: 2171854
• DOI: http://doi.org/10.5021/ad.2011.23.S3.S290

Abstract

Herein, we report a case of an 8-year-old girl with dapsone hypersensitivity syndrome (DHS) that occurred during the treatment of erythema elevatum diutinum. She had fever, gross hematuria, and malaise for three weeks after initiation of dapsone therapy. Five days after stopping dapsone treatment, she returned to the emergency clinic because of high fever, emesis, diarrhea, upper respiratory symptoms, and worsening of exanthematous eruptions. A diagnosis of DHS was made, and it improved with oral prednisone. We recommend that pediatric patients who are treated with dapsone need to be observed carefully for the development of DHS.

Keyword

Dapsone; Drug hypersensitivity syndrome; Erythema elevatum diutinum

MeSH Terms

Child
Dapsone
Diarrhea
Emergencies
Erythema
Fever
Hematuria
Humans
Hypersensitivity
Prednisone
Vasculitis, Leukocytoclastic, Cutaneous
Vomiting
Dapsone
Prednisone
Vasculitis, Leukocytoclastic, Cutaneous

Figure

• 

  Fig. 1 (A) Multiple, persistent, symmetric and erythematous to skin-colored papules and nodules on the extensor surfaces of the hands. (B) Close up view of the right hand, (C) right wrist, (D) right foot, (E) elbows and (F) knees.

• 

  Fig. 2 (A) Biopsy of an early lesion from the hand revealed widespread vasculitis in the small vessels of the dermis with fibrinoid deposits and extravasated red blood cells (H&E, ×100). (B) The infiltrates were composed of multiple small aggregates of histiocytes, neutrophils, and nuclear fragments (H&E, ×400).

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  Fig. 3 Symmetrically arranged, brightly erythematous macules and papules on trunk (A), arms (B), legs (C) and face with edematous swelling (D).

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