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PubMed1983

[Value of dapsone in the treatment of Horton's disease and rhizomelic pseudopolyarthritis].

The authors report two cases of Horton's disease and one case of rhizomelic pseudopolyarthritis treated initially with delta-cortisone with a very rapid favourable result. However, while under relatively high dose steroid therapy, there was recurrence of the disease in the three cases and the development of complications of steroid therapy prohibited the use of higher doses of delta-cortisone and even required its rapid weaning. In these three cases, the addition of 100 mg of dapsone per day led to a rapid control of the disease, with return to normal of the erythrocyte sedimentation rate and reduction of the doses of delta-cortisone. The authors discuss the place of dapsone in the treatment of Horton's disease and rhizomelic pseudopolyarthritis in the light of these three cases.

Aged↗
PubMed1982

The nose in lepromatous leprosy; bacteriological and histopathological studies of patients treated with dapsone monotherapy for varying periods of time.

A clinical, bacteriological and histopathological investigation of 62 patients with lepromatous leprosy attending a hospital in South India is reported, with particular emphasis on the activity of the disease in the nose. Twelve of the patients were from a group of 34 new patients who had been originally examined 5 years previously, and subsequently treated with dapsone (DDS) monotherapy. A further 50 lepromatous patients were also examined, who had been treated for periods ranging from 3 months to 10 years. With a few exceptions, there was good correlation between the clinical and histopathological findings in the skin and nose. Evidence of disease activity was demonstrated among three-quarters of the patients who had been treated for over a year. Failure to achieve quiescence was explained in most of the patients by failure to collect their dapsone treatment or to ingest it regularly as demonstrated by the determination of DDS/creatinine ratios on urine samples collected at the time of their visit to the clinic. Although the compliance of most patients was relatively satisfactory during the first 12 months of treatment, thereafter it deteriorated markedly. In contrast to the clinical, bacteriological, and histopathological evidence of disease activity in the skin and nose of most patients, in only one of the patients treated for more than a year was a positive nose-blow encountered. This suggests that the infectivity of DDS-treated lepromatous patients within this time and this diminished infectivity often persists despite poor drug compliance and continuing disease activity.

Dapsone↗
PubMed1981

Dapsone haemolysis in leprosy. A preliminary report.

Fifty one patients with leprosy from the Urban Leprosy Centre, attached to the Department of Dermatology and Venereology, Goa Medical College on treatment with Dapsone were studied from the point of view of development of haemolysis related to the drug. The findings are described and discussed. Anaemia developed in 60.7 percent of the patients during the course of treatment. It was mild and well compensated. The haemolytic effect of dapsone was related to the dose and duration of the treatment, being more manifested in doses above 50 mg daily.

Adolescent↗
PubMed1981

Disseminated cutaneous rhinosporidiosis treated with dapsone.

A case of disseminated cutaneous rhinosporidiosis is reported. The possibility of leprosy was excluded. Dapsone was found very effective in curing the cutaneous nodules. Though many chemotherapeutic agents have been tried both topically and internally, so far surgery is considered to be the effective method of treatment. Our experience with this case suggest that Dapsone may be a successful drug in cutaneous rhinosporidiosis.

Adult↗
PubMed1980

Assessment of self administration of dapsone in urine by out-patients attending field clinics.

Self administration of dapsone by 217 out-patients attending the field clinics in the Tindivanam Zone in Tamil Nadu was assessed by measurement of Dapsone/Creatinine ratios in urine. All the patients screened were on DDS 100 mg. daily, most of them for 6 days and the rest for 3 or 4 days in a week. The estimated irregularity of dapsone intake ranged from 15%--25% in the three different areas in this zone. The implications of the findings are discussed.

Dapsone↗
PubMedDate not supplied

N-chlorination of sulfamethoxazole and dapsone by the myeloperoxidase system.

It is known that activation of neutrophils or monocytes leads to the formation of hydrogen peroxide and the release of myeloperoxidase (MPO). We found that sulfamethoxazole was chlorinated by the combination of MPO, hydrogen peroxide, and chloride. The product, N-chlorosulfamethoxazole, is reasonably stable but reacts rapidly with a variety of compounds. The same product was formed by the reaction between sulfamethoxazole and hypochlorous acid, and dapsone was also N-chlorinated by the MPO system or hypochlorous acid. Although N-chlorination was not observed when sulfamethoxazole or dapsone was incubated with activated neutrophils, this is presumably because the chloramine products react rapidly with the cells. When radiolabeled sulfamethoxazole was incubated with activated neutrophils, covalent binding was observed. When radiolabeled sulfamethoxazole was incubated with MPO and hydrogen peroxide in the presence of albumin, covalent binding to the albumin occurred. Although binding to albumin occurred in the absence of chloride, it was increased by the presence of chloride. This suggests that N-chlorosulfamethoxazole may be one of several reactive metabolites of sulfamethoxazole that covalently bind to neutrophils. We suspect that covalent binding of arylamine drugs, such as sulfamethoxazole, to activated leukocytes is responsible for some of the adverse reactions associated with these drugs, especially adverse reactions that involve leukocytes such as agranulocytosis or drug-induced lupus.

Chlorides↗
PubMedDate not supplied

Dapsone syndrome in Goa.

Daspone syndrome was noted within six weeks of starting treatment in 1.3% of about 700 leprosy patients on MDT reporting to the skin department of Goa Medical College. Skin rash, photosensitivity, fever, lymphadenopathy, sore throat, hepatosplenomegaly, abnormal liver function tests and raised reticulocyte count were consistent features in all the patients. Other drugs, infectious mononucleosis and viral exanthemata were considered in differential diagnosis. Withdrawal of dapsone and administration of prednisolone controlled the condition within three to four weeks in majority of the patients. One patient died of ischemic heart disease unrelated to dapsone syndrome.

Adult↗
PubMedDate not supplied

Clinical and electroneurophysiological assessment of leprosy patients on dapsone monotherapy--a two year follow-up study.

Fifty-three persons with tuberculoid type of leprosy having a thickened nerve on one side and a clinically normal nerve on the contralateral side were studied before, during and after two years of therapy for electrophysiological abnormalities in apparently normal and in obviously thickened nerves. Twenty-seven patients had received treatment with dapsone 100 mg orally and 26 cases had received rifampicin therapy. It was found that there was no extension of anesthesia or diminution of motor power over a period of two years. There was no significant difference between the initial and final recordings of motor and sensory nerve conductions if aggregate figures were taken. However, taking individual cases, deterioration in nerve conduction (increased latency and decreased velocity) was found in two patients, of whom one had received dapsone and the other had received rifampicin.

Adolescent↗
PubMed1995

[Hypersensitivity syndrome caused by dapsone. Transient circulating clone T].

INTRODUCTION: Hypersensitivity is a rare side-effect of dapsone. The most complete clinical presentation associates papulous exanthema, lymph node enlargement, liver cell failure and an increase in mononuclear and eosinophil counts. CASE REPORT: A 45-year-old woman developed hypersensitivity to dapsone when this drug was used to treat corticoid-dependent asthma. A transient circulating clone T was demonstrated by Southern blot during the acute phase. The clinical manifestations and laboratory findings returned to normal under systemic corticosteroid treatment. When corticoids were tapered off, hypersensitivity reactions began to progress again. DISCUSSION: Transient circulating clone T, as observed here, emphasizes the importance of close surveillance and long-term follow-up in drug-induced hypersensitivity syndromes.

Anti-Asthmatic Agents↗
PubMed1996

[Dapsone (4,4'-diaminodiphenyl sulfone) resolved severe leukocytopenia and thrombocytopenia in a patient with systemic lupus erythematosus].

A 47 year old woman was presented in June, 1994 with a ten years history of systemic lupus erythematosus. Since six months before first visit to our hospital, she had experienced general malaise, myalgia and persistent low grade fever. Among this period, titers of anti DNA antibody in her blood were gradually increased. She had been treated with the prednisolone which was step-wisely increased up to 15 mg/day, but her symptoms had been worsened. On admission, physical examination showed low grade fever and erythema on her both hands. Investigations showed her white blood cell count 1400/microliter, platelet 90000/microliter, positive test result for ANA, anti DNA antibody and anti Sm antibody, low serum concentrations of complements, and persistent proteinuria. She was treated with 60 mg/day of oral prednisolone. Though her symptoms and immunological abnormalities were gradually improved, her platelet count and white blood cell count were gradually decreased to 50000/microliter and 1400/microliter in August, respectively. Platelet associated IgG was increased (102.9 ng/10(7) cells). In spite of the various trials of treatment, such as plasmapheresis, high-dose intravenous gammaglobulin, and cyclophosphamide, the white blood cell and platelet number could not be raised. Finally, the administration of 75 mg/day of dapsone brought a significant rise in both blood cell counts. Thus being certainly effective against leukocytopenia and thrombocytopenia, dapsone should be considered an one of the beneficial therapeutic procedures for refractory autoimmune leukocytopenia and thrombocytopenia in SLE patients.

Anti-Infective Agents↗
PubMedDate not supplied

Dapsone syndrome--a five year retrospective analysis.

Seventeen cases of dapsone syndrome were seen in five years from 1992 onwards. Their mean age was 27.8 years (range 11 to 60 years). Male to female ratio was 1.1:1. Of these cases, seven had confirmed leprosy, nine were cases of suspected leprosy and one case had lichen planus. On an average, they developed the symptoms 27 days after the intake of dapsone. The cutaneous lesions were in the form of erythematous papules and plaques (13 cases), eczematous lesions (four cases) and associated bullous lesions (two cases). The other manifestations were: fever (16 cases), pruritus (15 cases), lymphadenopathy (14 cases), hepatomegaly (10 cases), icterus and oral erosions (five cases each), photosensitivity (four cases) and splenomegaly (two cases). Previous drug allergy was present in four cases. Elevated ESR and liver enzyme levels were invariable findings. Raised bilirubin levels and hemolytic anaemia were seen in eight cases. Apart from one case with hepatic encephalopathy, all other cases had a favourable outcome either on conservative management (eight cases) or on oral corticosteroids (eight cases). Oral provocation test was done in two cases with positive response while intradermal test was not very reliable.

Adolescent↗
PubMed1976

Treatment of relapsing polychondritis with dapsone.

Three patients with relapsing polychondritis were treated successfully with dapsone. Mounting evidence suggests an immune-related pathogenesis for relapsing polychondritis. Dapsone may be effective in certain immune-related diseases because of its inhibition of lysosomal enzymes.

Aged↗
PubMed1979

Relapsing polychondritis: unusual neurological findings and therapeutic efficacy of dapsone.

Relapsing polychondritis is a rare disease of undetermined cause. The most frequently seen symptom is redness and swelling of the cartilaginous ear, followed by cartilage inflammation elsewhere in the body. Our five cases had neurologic symptoms that posed diagnostic difficulties. Because vasculitis is not uncommon in relapsing polychondritis, it was difficult to determine whether these neurologic symptoms were attributable to relapsing polychondritis or to other unrelated causes. In our cases, specific neurologic complaints were caused by a concomitant but unrelated disease, rather than by relapsing polychondritis. We add five additional documented cases to the medical literature and confirm the therapeutic efficacy of dapsone in the treatment of this unusual disease.

Adult↗
PubMed1980

Pemphigus vegetans: its relationship to eosinophilic spongiosis and favorable response to dapsone.

Two cases of pemphigus vegetans are presented. One, an example of the Hallopeau type of the disease, was found to have early lesions that simulated eosinophilic spongiosis clinically and histologically. The other had lesions that were largely confined to the oral mucosa and was also considered to be the Hallopeau type of the disease in a limited form. The cases of these two patients were compared with a typical case of eosinophilic spongiosis. All were controlled with dapsone therapy.

Dapsone↗
PubMed1975

Identification and quantitation of impurities in dapsone preparations.

Chromatographic and fluorometric procedures were developed to isolate and quantitate small amounts of 2,4'-diamino-diphenyl sulfone and 4-aminodiphenyl sulfone in pharmaceutical preparations of the antileprosy drug 4,4'-diaminodiphenyl sulfone (dapsone). Identification was accomplished by comparison with authentic compounds employing UV absorption, fluorometry, and mass spectrometry in addition to TLC and high-pressure liquid chromatography.

Chromatography, Thin Layer↗
PubMed2002

Effects of H(2)-receptor antagonists on dapsone-induced methaemoglobinaemia in rats.

Dapsone (DDS) (4,4'diaminodiphenylsulfone), the drug of choice for the treatment of leprosy, frequently induces haemolytic anaemia and methaemoglobinaemia. N-hydroxylation, one of the major pathways of biotransformation, has been constantly related to the methaemoglobinaemia observed with the use of the drug. In order to determine the reversible inhibition of this toxicologic bioactivation pathway without changing the detoxification pathways of the drug or cytosolic acetylation, cimetidine (CIM), ranitidine and famotidine were administered in combination with DDS to male Wistar rats weighing 200-220 g. The animals were divided into nine groups of eight: group 1 received a single dose of 40 mg kg (-1) DDS in dimethylsulfoxide (DMSO) and groups 2-4 received the same treatment as group 1 but after the administration of a single dose of 100, 150 and 200 mg kg (-1) CIM, respectively, injected 2 h prior DDS administration. Groups 5-9 received the same treatment as group 2 but after the treatment of ranitidine (50 and 100 mg kg (-1) intraperitoneally (i.p.) in 200 microl DMSO) and famotidine (10, 50 and 100 mg kg (-1) i.p. in 200 microl DMSO), respectively. The animals were then anaesthetized with ether and blood was collected from the aorta for the determination of plasma DDS and monoacetyldapsone concentrations by HPLC and later for the determination of methaemoglobinaemia by spectrophotometry. CIM showed a higher affinity for cytochrome P-450 than famotidine and ranitidine. The results obtained showed the potentiality of the pharmacological effects of DDS with a low risk of adverse reactions, especially methaemoglobinaemia, which is dose dependent.

Animals↗