Volume : 12, Issue : 10, October – 2025
Title:
ERYTHRODERMA INDUCED BY LONG-TERM DAPSONE THERAPY IN LEPROSY: A RARE BUT SERIOUS ADVERSE REACTION
Authors :
Kailash Ramesh Bhovi*, Dr Shantveer Halcher
Abstract :
Abstract:
Background: Erythroderma, or generalized exfoliative dermatitis, is a rare but potentially fatal dermatological emergency, most often secondary to dermatoses, malignancies, or drugs. Dapsone, an essential component of multidrug therapy (MDT) for Hansen’s disease, is usually well tolerated but can occasionally trigger severe adverse drug reactions (ADRs), including hypersensitivity, Stevens–Johnson syndrome, and, rarely, erythroderma.
Case Presentation: We report a 55-year-old male with multibacillary leprosy on WHO-recommended MDT for two years, who presented with progressive diffuse erythema, scaling, pruritus, fever, and malaise. Examination revealed erythroderma involving >90% of body surface area with cervical lymphadenopathy. Laboratory findings showed anaemia, leucocytosis, and hypoalbuminemia, while skin biopsy supported drug-induced erythroderma. MDT was discontinued and supportive therapy with corticosteroids, emollients, antihistamines, and nutritional care was initiated. A modified MDT regimen excluding dapsone was introduced. The patient improved markedly within three weeks, with no recurrence on follow-up.
Discussion: Dapsone-induced erythroderma is exceedingly rare and can occur even after long-term therapy. Causality was assessed using the Naranjo Adverse Drug Reaction Probability Scale, with a score of 7, categorizing this as a probable ADR. Differentiating drug-induced erythroderma from lepra reactions is critical in endemic regions. Clinical pharmacists contribute significantly by assessing ADRs, ensuring pharmacovigilance reporting, guiding MDT modification, and preventing re-exposure.
Conclusion: This case emphasizes the need for continuous vigilance for ADRs during prolonged MDT and the pivotal role of clinical pharmacists in optimizing therapy and patient safety.
Keywords: Dapsone, Erythroderma, Leprosy, Adverse Drug Reaction, Clinical Pharmacist
Cite This Article:
Please cite this article in press Kailash Ramesh Bhovi et al., Erythroderma Induced By Long-Term Dapsone Therapy In Leprosy: A Rare But Serious Adverse Reaction, Indo Am. J. P. Sci, 2025; 12(10).
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