Dapsone is a sulphone antibiotic mainly used to treat leprosy and dermatitis herpetiformis that has anti-inflammatory, immunosuppressive, antibacterial and antibiotic properties.

It is also available as a topical gel for acne vulgaris.

Mechanism of action:
Dapsone interferes with the bacterial synthesis of folic acid which inhibits nucleic acid synthesis.
As an anti-inflammatory agent, it inhibits the myeloperoxidase-H2O2-halide-mediated cytotoxic system preventing the accumulation of hypochlorous acid which reduces the tissue damage during inflammation.

Side effects:
Common and relatively minor side effects: nausea or vomiting; headache; blue discolouration (cyanosis) of fingertips (more common) and toes (less common).
Less common and more important: anaemia; allergy; psychosis
Uncommon: peripheral neuropathy (especially subtle onset of motor neuropathy causing a weakness of the foot and hand muscles) – symptoms mostly resolve within 12 months of cessation of dapsone; cases of foot drop have been reported.

Liver function need to be monitored in those who are on dapsone.

Trade names: Aczone; Dapsone
Chemical Formula: C12H12N2O2S

Podiatry Significance:
Awareness of the signs of peripheral neuropathy in the lower limb and the cyanosis in the toes.

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