Reinstatement of dapsone following hypersensitivity.

Sir, Dapsone therapy can cause severe adverse reactions known as the sulphone or dapsone hypersensitivity syndrome (DS). The most common presenting symptom is a maculopapular or exfoliative rash confined to either the upper limbs or the forehead, but it can also be disseminated. The sequence of symptoms – dermatitis, lymphadenopathy notably along the posterior border of the sternomastoid muscles and hepatitis – forms a particular pattern. Opinions vary on desensitization after DS. In 1963, Browne (1) reported 52 leprosy patients in whom desensitization was attempted; only 2 cases had severe dermatitis after every dose of dapsone. Since then there have only been two reports of successful attempts to reintroduce dapsone in HIV patients (2, 3). This is the first report of the reintroduction of dapsone after DS in a patient with dermatitis herpetiformis.