DAPSONE-INDUCED METHEMOGLOBINEMIA IN A PATIENT WITH WELLS SYNDROME: A CASE REPORT

Case: A 24 year old woman, was admitted to our outpatient clinic with common urticarial lesions after treatment with amoxicillin clavulanic acid. Lesions were annular, erythematous, indurated plaques with changing diameters.. A relapse was occured after oral methylprednisolone/cetirizine/topical mometasone treatment. After treatment resistance with hydroxychloroquine for 6 weeks, dapsone was started. On the 5th day of 2x100 mg dapsone treatment severe headache, dizziness, palpitations, fatigue, was considered methemoglobinemia: Dapsone induced methemoglobinemia was shown with 5.10 % methemoglobin level and followed up with supportive treatment. Conclusion: The basis for the treatment of Wells syndrome is corticosteroids; while antihistamines, hidroksikloroquin, griseofulvin, dapsone and immunosupressants (cyclosporine, azathioprine, tacrolimus) can be used. Patients using dapsone should be monitored closely for methemoglobinemia and treated effectively as needed.