Dapsone adverse drug reaction

Reilly TP, Woster PM, Svensson CK. Methemoglobin formation by hydroxylamine metabolites of sulfamethoxazole and dapsone implications for differences in adverse drug reactions. J Pharmacol Exp Ther 1999 288 951-959. 

Dapsone (Avlosulfon) is a member of a class of chemical agents known as the sulfones. Dapsone is especially effective against M. leprae and is used with rifampin as the primary method of treating leprosy. Dapsone appears to exert its antibacterial effects in a manner similar to that of the sulfonamide drugs that is, dapsone impairs folic acid synthesis by competing with PABA in bacterial cells. Primary adverse effects associated with dapsone include peripheral motor weakness, hypersensitivity reactions (skin rashes, itching), fever, and blood dyscrasias, such as hemolytic anemia. 

Dapsone in combination with trimethoprim is also used for the treatment of mild to moderate first episodes of TCP, or alone for PCP prophylaxis [115, 198]. The most frequent adverse events are dose related metheglobinemia and hemolytic anemia. Since multi-drug therapy began to be used in leprosy patients, an increasing number of a rare, idiosyncratic reaction with multiorgan involvement... 

Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction, mostly drug related or associated with viral infections. It can also manifest as a reaction to dapsone therapy in the setting of HTV infection when used as prophylaxis for pneumocystis jirovecii pneumonia [75 ]. 

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