Abstract
A 50-year-old male Sudanese patient presented with a three-week history of jaundice, high-grade fever, and mucocutaneous eruption. For last months he was on compound therapy for leprosy, which had been confirmed recently. The patient’s face was prominent, along with the erythematous dusky morbilliform rash covering all the body. On examination, we detected hepatosplenomegaly and generalized lymphadenopathy. Laboratory investigations revealed hepatorenal impairment, and hematological analysis revealed leukocytosis mainly due to eosinophilia. The clinical and laboratory findings interpretation ranked DRESS or Drug-Induced Hypersensitivity Syndrome (DIHS) on top of possible causes before Dapsone Hypersensitivity Syndrome (DHS) and lepra reactions. We promptly discontinued MDT, admitted him to the dermatological ward. Two skin biopsies were sent to two different histopathologists, MF was suggested by one and Sezary syndrome by the other one. Besides the general conservative measures and vital functions monitoring, he received systemic and topical steroids. However, unfortunately, within the next three weeks, his condition deteriorated, and passed away from multi-systems failure.
Highlights
Drug Reaction with Eosinophilia and SystemicSymptoms (DRESS). referred to as Drug-Induced Hypersensitivity Syndrome (DIHS) is a distinct, potentially life-threatening adverse reaction
We present a patient who was referred to the dermatology clinic, severely ill with fever, generalized skin rash, jaundice, generalized lymphadenopathy, and cough
The patient reported the use of dapsone as part of multidrug therapy (MDT)
Summary
Induced Hypersensitivity Syndrome (DIHS) is a distinct, potentially life-threatening adverse reaction. It is seen in children and adults most often as a morbilliform cutaneous eruption with fever, lymphadenopathy, hematologic abnormalities, and multiorgan manifestations [1,2]. Especially phenytoin, carbamazepine, phenobarbital, and sulfonamides, such as dapsone and sulfasalazine, are the most common causes of DRESS. We report a case of fatal DRESS caused by dapsone (dapsone hypersensitivity syndrome) in a 50-year-old Sudanese male patient
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