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Dermatology · Leprosy: dapsone hypersensitivity
Sample itemFour weeks after starting dapsone, a patient develops fever, exfoliative dermatitis, hepatitis and eosinophilia. What is this called?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Dapsone hypersensitivity (DRESS-like) syndrome
Dapsone syndrome is an idiosyncratic hypersensitivity appearing 3 to 6 weeks after starting therapy, associated with HLA-B*13:01. The drug must be stopped, and corticosteroids and supportive care are given.
Option by option
A. Type 1 reaction
Type 1 reaction presents with inflamed lesions and neuritis.
B. Dapsone hypersensitivity (DRESS-like) syndrome (correct)
Correct. Timing and multisystem features indicate dapsone syndrome.
C. Lucio phenomenon
Lucio phenomenon is a necrotising vasculitis.
D. Erythema nodosum leprosum
ENL presents with painful nodules and arises in lepromatous leprosy independent of dapsone.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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