Drug rash with eosinophilia and systemic symptoms syndrome

(Redirected from DRESS syndrome)

Background

  • Known as DRESS syndrome
  • A severe adverse drug reaction
  • Usually begins within 8 weeks of starting a new drug
  • 8-10% mortality
  • Previously known as Dilantin Hypersensitivity Syndrome or Anti-convulsant hypersensitivity syndrome
  • However, many other medications, particularly antibiotics
  • A virus-drug interaction with HHV-6, HHV-7, EBV, and CMV may be a form of pathogenesis as well[1]

Associated Drugs

Clinical Features

Differential Diagnosis

Evaluation

Management

  • Discontinue suspected drug
  • Supportive care: antipyretic, anti-pruritic
  • Fluid management as in burn
  • Systemic steroids and/or cyclosporin/immunosuppressants in severe cases (controversial)
    • Hepatitis, pneumonitis, extensive exfoliative dermatitis
    • Other severe systemic manifestations
  • Family counseling as possible genetic component

Disposition

  • Admit

See Also

External Links

References

  1. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. Sonal Choudhary, Michael McLeod, Daniele Torchia, Paolo Romanelli. J Clin Aesthet Dermatol. 2013 Jun; 6(6): 31–37.
  2. Herman AO. Antipsychotic Linked to Potentially Fatal Skin Reaction. Physician's First Watch. Dec 12, 2014. http://www.jwatch.org/fw109630/2014/12/12/antipsychotic-linked-potentially-fatal-skin-reaction?query=pfw&jwd=000013530619&jspc=.
  3. Callot V, Roujeau JC, Bagot M, et al. Drug-induced pseudolymphoma and hypersensitivity syndrome. Two different clinical entities. Arch Dermatol. 1996;132:1315–1321.
  4. Peyriere H, Dereure O, Breton H, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. 2006;155:422–428.