One more case of Sulfone Syndrome

Abstract

A case of a patient was reported presenting fever, pruritus, malaise, and erythroderma surrounding hypocromic macules in the anterior aspect of the trunc after the beggining of the leprosy treatment. Biopsies of lesions showed regular epitelial dermatitis and pleiomorphic lymphocitic infiltrate with intense epidermotropism and follicular involvement. Bacilli in nerves and macrophages were detected in all the biopsies. Laboratory
examens demonstrated anaemia (erytrocytes- 3,300,000/mm3; Hb - 9,2%) and leucocitosis (20,800 leucocytes/mm3) with 40% of lymphocytes and polymorphism of these cells. These manifestations were labelled as "Sulfone Syndrom" despite the lack of other components. The authors considered atypical lymphocitosis to be the hall mark of this Syndrom and called the attention to the lymphocitic pleiomorphism in intense epidermotropism and follicular involvement observed in the histopathological examinations done. This picture disappeared in the posterior biopsies. They discussed why erythroderm did not involve hypochromic macules of leprosy and considered that an autosensitization phenomena would result in the persistency of the erythroderma even after sulfone was withdrawn.