Dapsone hypersensitivity syndrome

Dapsone hypersensitivity syndrome (DHS) was first reported by Lowe and Smith in 1949 in Nigeria and was termed “dapsone syndrome” by Allday and Barnes in 1951. DHS is a drug-induced hypersensitivity syndrome (DIHS) caused by dapsone 404’-diaminodiphenylsulfone (DDS). DHS is characterized by fever, rash, lymphadenopathy, and hepatitis, which usually develop after patients receive DDS for 5 to 6 weeks. Epidemiological studies have estimated DHS prevalence and fatality rates of 1.4% and 9.9%, respectively. Until recently, the “wait and see” approach was used for patients with suspected DHS. Herein, we review recent developments in DHS research, focusing on its etiology, pathogenesis, diagnosis, and prevention, to make DDS a safer medication for most of the population through the prospective exclusion of susceptible patients before DDS administration.

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