Dapsone-induced drug reaction with eosinophilia and systemic symptoms syndrome, misdiagnosed as lymphoma

Abstract

2 Internal Medicine, Asan Medical Center, Seoul, Korea Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening adverse drug reaction with systemic manifestations. Dapsone is known to be useful for treatment of leprosy and various dermatologic conditions. We report a patient with prurigo pigmentosa who developed DRESS syndrome after dapsone treatment. She presented with lymphadenopathy, fever, eosinophilia, skin rash, and elevated liver enzymes. Initial lymph node and skin biopsy was suggestive of peripheral T-cell lym- phoma. Initially, she was treated with chemotherapy. A week later after complete remission of skin symptoms, new skin lesions re- curred. TCR-gene rearrangement was examined to show negative results and she was diagnosed as dapsone induced DRESS syn- drome. This case emphasizes the importance of differential diagnosis of lymphoma and DRESS syndrome. (Allergy Asthma Respir Dis 2013;1:400-404)