Dapsone hypersensitivity syndrome with circulating 190-kDa and 230-kDa autoantibodies.

Abstract:

:Dapsone has potent anti-inflammatory effects, and is used in the treatment of leprosy, cutaneous vasculitis, neutrophilic dermatoses, and dermatitis herpetiformis and other blistering disorders. However, it may cause severe adverse reactions such as hypersensitivity syndrome, which is characterized by fever, skin rash, hepatitis and lymphadenopathy. We report a 44-year-old female Korean patient with dapsone hypersensitivity syndrome (DHS) that presented as a bullous skin eruption. The patient had a 1-year history of urticarial vasculitis, treated with antihistamines, prednisolone and dapsone. Although the skin lesions improved, she reported fever, nausea, abdominal pain, jaundice, fatigue and skin rashes. On physical examination, there were generalized erythematous macules and purpura with facial oedema that developed into vesicles on the upper limbs. Histological examination of a skin biopsy of a vesicular lesion found subepidermal oedema with a mixed inflammatory cell infiltrate, including eosinophils in the dermis. Indirect immunofluorescence testing using normal foreskin as substrate revealed IgG deposits in the basement membrane zone. Circulating autoantibodies against antigens of 190 and 230 kDa were found by immunoblotting analysis using epidermal extracts. This case illustrates DHS with the formation of circulating autoantibodies.

journal_name

Clin Exp Dermatol

authors

Chun JS,Yun SJ,Kim SJ,Lee SC,Won YH,Lee JB

doi

10.1111/j.1365-2230.2009.03527.x

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

e798-801

issue

8

eissn

0307-6938

issn

1365-2230

pii

CED3527

journal_volume

34

pub_type

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