To the Editor.—
Dapsone is a sulfone commonly used in the treatment of dermatological diseases, eg, leprosy and dermatitis herpetiformis and, on occasion, in the treatment of acne conglobata, erythema elevatum diutinum, relapsing polychondritis, and actinomycetoma. The side effects of dapsone, including hemolytic anemia and methemoglobinemia, agranulocytosis, diverse dermatoses, neuropathy, and upper gastrointestinal disturbances are generally well appreciated. Recently, I noted three patients who were on dapsone regimens (one patient for Hailey-Hailey disease, and two patients for dermatitis herpetiformis) who developed abnormalities in the results of their liver function tests.
Report of Cases.—
All three patients were healthy aside from their dermatological conditions; they had normal glucose-6-larlyhate dehydrogenase levels, had regularly screened normal blood counts and methemoglobin levels, and normal BUN, serum phosphorus, calcium, glucose, cholesterol, total protein, albumin, and alkaline phosphatase levels. Abnormal levels of lactic dehydrogenase, SGOT, and total bilirubin were observed consistently (Table).Patient 1 began taking