Dapsone-induced erythroderma with Beau's lines

In 1989, a 35-year-old female with borderline lepromatous leprosy developed dapsone-induced erythroderma, characterized by a sudden onset of a generalized skin rash and the appearance of Beau's lines on her fingernails, which are transverse lines indicating a temporary arrest of nail growth. The patient's condition improved rapidly after dapsone was discontinued and she was treated with systemic corticosteroids and a topical emollient. The case highlighted the need for urgent dermatological referral for leprosy patients who develop a skin rash within the first two months of multidrug therapy, due to the potential severity of dapsone hypersensitivity reactions. The authors suggested that the increasing incidence of dapsone hypersensitivity, which can be fatal, necessitates careful monitoring and immediate action when symptoms appear.