Biomaterial Database

Case Report of Methemoglobinemia in a Toddler Secondary to Topical Dapsone Exposure. 2016

Danielle M Graff, and George M Bosse, and Janice Sullivan

Departments of Pediatrics and dmgraf02@louisville.edu.

Aczone gel 5% contains dapsone and is a commonly used topical dermatologic therapy for acne in adolescents and adults. We describe the first reported pediatric case of a previously healthy girl presenting with acute onset of methemoglobinemia after exposure to her sibling's Aczone gel. The patient was successfully treated with methylene blue initially and subsequently needed an additional dose for rebound methemoglobinemia. This case demonstrates the complications of systemic absorption of dapsone in the pediatric population resulting in clinically significant methemoglobinemia from a single topical application.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D008708	Methemoglobinemia	The presence of methemoglobin in the blood, resulting in cyanosis. A small amount of methemoglobin is present in the blood normally, but injury or toxic agents convert a larger proportion of hemoglobin into methemoglobin, which does not function reversibly as an oxygen carrier. Methemoglobinemia may be due to a defect in the enzyme NADH methemoglobin reductase (an autosomal recessive trait) or to an abnormality in hemoglobin M (an autosomal dominant trait). (Dorland, 27th ed)	Methemoglobinemias
D003622	Dapsone	A sulfone active against a wide range of bacteria but mainly employed for its actions against MYCOBACTERIUM LEPRAE. Its mechanism of action is probably similar to that of the SULFONAMIDES which involves inhibition of folic acid synthesis in susceptible organisms. It is also used with PYRIMETHAMINE in the treatment of malaria. (From Martindale, The Extra Pharmacopoeia, 30th ed, p157-8)	Diaminodiphenylsulfone,Sulfonyldianiline,4,4'-Diaminophenyl Sulfone,Avlosulfone,DADPS,Dapsoderm-X,Dapson-Fatol,Diaphenylsulfone,Disulone,Sulfona,4,4' Diaminophenyl Sulfone,Sulfone, 4,4'-Diaminophenyl
D003879	Dermatologic Agents	Drugs used to treat or prevent skin disorders or for the routine care of skin.	Agent, Dermatologic,Agent, Dermatological,Agents, Dermatologic,Dermatologic Agent,Dermatological Agents,Agents, Dermatological,Dermatological Agent
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000287	Administration, Topical	The application of drug preparations to the surfaces of the body, especially the skin (ADMINISTRATION, CUTANEOUS) or mucous membranes. This method of treatment is used to avoid systemic side effects when high doses are required at a localized area or as an alternative systemic administration route, to avoid hepatic processing for example.	Drug Administration, Topical,Administration, Topical Drug,Topical Administration,Topical Drug Administration,Administrations, Topical,Administrations, Topical Drug,Drug Administrations, Topical,Topical Administrations,Topical Drug Administrations