A 36-year-old woman had erythematous confluent maculopatches on her face, trunk, and palm. she was diagnosed as erythema multiforme. After she was treated with dapsone, she presented with jaundice, fever and abrupt aggravation of the skin lesion. She ...
A 36-year-old woman had erythematous confluent maculopatches on her face, trunk, and palm. she was diagnosed as erythema multiforme. After she was treated with dapsone, she presented with jaundice, fever and abrupt aggravation of the skin lesion. She had elevated hepatic enzymes, bilateral cervical lymphadenopathy, and splenomegaly. The possibility of angioimmunoblastic T-cell lymphoma was raised as an exicisional biopsy of her cervical node showed atypical lymphoid hyperplasia with immunohistochemical results compatible with angioimmunoblastic T-cell lymphoma. As her clinical course was highly suggestive of dapsone-induced hypersensitivity syndrome, we assumed that the cervical lymphadenopathy might be a pseudolymphoma after systemic hypersensitivity reaction. In a transjugular liver biopsy no evidence of lymphomatous involvement was found, and she was recovered without chemotherapy but low dose prednisolone for dapsone induced hypersensitivity. Gradually the skin lesion was improved and the cervical lymph node enlargement regressed. Her hepatic enzymes were also normalized in 3 weeks of prednisolone and the corticosteroids were then tapered for a month. In follow-up CT scans after 3 months and 6 months of the disease manifestation, the cervical lymph nodes enlargement was not shown any longer, spleen size was normalized, and no other findings suggestive of lymphoma progression was observed. Here we present a case of lymphoadenopathy mimicking angioimmunoblastic T-cell lymphoma as an adverse reaction of dapsone.