Chapter 225 Dapsone

Question 1

diseases with consistent response to dapsone

Answer 1

BLED

• bullous SLE
• linear IGA dermatosis/chronic bullous disease of childhood
• erythema elevatom diutinum
• dermatitis herpetiformis

Question 2

diseases with sporadic response to dapsone

Answer 2

collagen vascular / autoimmune diseases

acne

Question 3

unifying features of diseases responsive to dapsone

Answer 3

neutrophil and eosinophil granulocytosis

Question 4

infections responsive to dapsone

Answer 4

leprosy
actinomycetoma
rhinosporidiosis

Question 5

adverse effects of dapsone

Answer 5

SHAMMoN

sulfone syndrome
hemolysis
agranulocytosis
methemoglobinemia
mononucleosis like hypersensitivity
neuropathy

Question 6

anti inflammatory mechanism of action of dapson

Answer 6

inhibits neutrophil chemotaxis response to F-met-leu-phe and LTB4

inhibits neutrophil adherence to skin-localized IgA and endothelium

inhibits release of inflammatory mediators IL 8, TNF alpha, PD2

inhibits myeloperoxidase H202 halide cytotoxic burst

^myeloperoxidase is found in azurophilic granules of neutrophils and lysosomes of monocytes and this enzyme coverts hydrogen peroxide and chloride ions to hypochlorous acid needed for oxidative burst

Question 7

alternative if patients has severe allergy to dapsone

Answer 7

sulfapyridine

Question 8

dapsone is metabolized in the liver

what are the two hepatic processes of dapsone metabolism

Answer 8

N hydroxylation

acetylation

Question 9

triad of sulfone syndrome

Answer 9

fever
rash
hepatitis