Drug rash with eosinophilia and systemic symptoms information
"DRESS" redirects here. For other uses, see Dress (disambiguation).
Not to be confused with Dressler syndrome.
Medical condition
Drug rash with eosinophilia and systemic symptoms
Other names
Drug reaction with eosinophilia and systemic symptoms, DRESS, DRESS syndrome, drug-induced hypersensitivity syndrome, DIHS, drug hypersensitivity syndrome, DHS, drug-induced delayed multiorgan hypersensitivity syndrome, DIDMOHS, (formerly) drug-induced pseudolymphoma
Specialty
Immunology, dermatology
Drug rash with eosinophilia and systemic symptoms or drug reaction with eosinophilia and systemic symptoms (DRESS), also termed drug-induced hypersensitivity syndrome (DIHS), is a rare reaction to certain medications. It involves primarily a widespread skin rash, fever, swollen lymph nodes, and characteristic blood abnormalities such as an abnormally high level of eosinophils, low number of platelets, and increased number of atypical white blood cells (lymphocytes). However, DRESS is often complicated by potentially life-threatening inflammation of internal organs and the syndrome has about a 10% mortality rate.[1] Treatment consists of stopping the offending medication and providing supportive care. Systemic corticosteroids are commonly used as well but no controlled clinical trials have assessed the efficacy of this treatment.[2]
DRESS is classified as one form of severe cutaneous adverse reactions (SCARs). In addition to DRESS, SCARs includes four other drug-induced skin reactions: the Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), Stevens–Johnson/toxic epidermal necrolysis overlap syndrome (SJS/TEN) and acute generalized exanthematous pustulosis (AGEP). The SCARs disorders have similar disease mechanisms. New strategies are in use or development to screen individuals at risk for DRESS to aid them in avoiding medications that increase the risk of DRESS. Alternative medications are used in all individuals testing positive for these predispositions.[3]
Prior to 1996, there were numerous reports on individuals presenting with a medication-induced disorder now recognized as the DRESS syndrome. For example, anticonvulsants in the 1930s, phenytoin in 1950, and other medications in the ensuing years were reported to do so. The reports often named the disorder based on the medication evoking it, e.g. the anticonvulsant hypersensitivity syndrome, allopurinol hypersensitivity syndrome, and dapsone hypersensitivity syndrome.[4] In 1996, however, the term DRESS syndrome was coined in a report attempting to simplify the terminology and consolidate these various clearly related syndromes into a single underlying disorder.[5][6]
^Walsh SA, Creamer D (January 2011). "Drug reaction with eosinophilia and systemic symptoms (DRESS): a clinical update and review of current thinking". Clinical and Experimental Dermatology. 36 (1): 6–11. doi:10.1111/j.1365-2230.2010.03967.x. PMID 21143513. S2CID 16048518.
^Ganeva M, et al. (2008). "Carbamazepine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: report of four cases and brief review". International Journal of Dermatology. 47 (8): 853–860. doi:10.1111/j.1365-4632.2008.03637.x. PMID 18717872. S2CID 34572606.
^Adler NR, Aung AK, Ergen EN, Trubiano J, Goh MS, Phillips EJ (2017). "Recent advances in the understanding of severe cutaneous adverse reactions". The British Journal of Dermatology. 177 (5): 1234–1247. doi:10.1111/bjd.15423. PMC 5582023. PMID 28256714.
^Cho YT, Yang CW, Chu CY (2017). "Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System". International Journal of Molecular Sciences. 18 (6): 1243. doi:10.3390/ijms18061243. PMC 5486066. PMID 28598363.
^Bocquet H, Bagot M, Roujeau JC (December 1996). "Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS)". Semin Cutan Med Surg. 15 (4): 250–7. doi:10.1016/S1085-5629(96)80038-1. PMID 9069593.
drug reactions with eosinophiliaandsystemicsymptoms (DRESS). Drugs that has, allopurinol, nonsteroidal anti-inflammatory drugs (NSAIDs), some antipsychotics...
Diagnosis is based on symptoms, supported by a skin biopsy or blood tests. While no cure is known, treatment may improve symptoms. Medications used include...
culprit drug. Drug Reaction withEosinophiliaandSystemicSymptoms usually occurs between 15 and 40 days after exposure. Toxic epidermal necrolysis and Stevens–Johnson...
to the drug allergy develops, can be employed. Adverse drug reaction Drug reaction witheosinophiliaandsystemicsymptomsDrug intolerance Drug tolerance...
severe allergic reactions have been reported including drugrashwitheosinophiliaandsystemicsymptoms (DRESS syndrome) According to the manufacturer, strontium...
than 1,500/mL of blood eosinophilia for more than six months in a row, along with hypereosinophilic disease signs andsymptoms. Lack of an underlying...
develop to tetrazepam and it is considered to be a potential allergen. Drugrashanddrug-induced eosinophiliawithsystemicsymptoms is a known complication...
to infections and diseases, can lead to tissue damage when it is done in excess. Local andsystemicsymptoms become more widespread and are compounded...
together with SJS, a SJS/TEN, anddrug reaction witheosinophiliaandsystemicsymptoms. It is called SJS when less than 10% of the skin is involved and an...
does not entail itching or gastrointestinal symptoms, syncope presents with pallor rather than a rash, and a panic attack may have flushing but does not...
weeks of therapy. Drug reaction witheosinophiliaandsystemicsymptoms syndrome can occur during the first few weeks of therapy with minocycline. Minocycline...
Drug-induced pigmentation Drug-induced urticaria Drug reaction with eosinophiliaandsystemicsymptoms Erythema multiforme major (erythema multiforme minor–erythema...
necrolysis, andDrug reaction witheosinophiliaandsystemicsymptoms. Reported blood abnormalities with its use include lymphopenia, eosinophilia, and atypical...
including fascia, and there is a clinical overlap with eosinophilic fasciitis, eosinophilia-myalgia syndrome, and the Spanish toxic oil syndrome.: 171 Morphea...
Strock SB (2015). "Drug Reaction withEosinophiliaandSystemicSymptoms Syndrome Probably Induced by a Lamotrigine-Ginseng Drug Interaction". Pharmacotherapy...
coccidioidomycosis signs andsymptoms include a profound feeling of tiredness, loss of smell and taste, fever, cough, headaches, rash, muscle pain, and joint pain....
SCARs includes five syndromes: Drug reaction witheosinophiliaandsystemicsymptoms (i.e. DRESS syndrome, also termed Drug-induced hypersensitivity syndrome...
DRESS syndrome (Drug Reaction withEosinophiliaandSystemicSymptoms) is a severe immunological drug reaction. It differs from other drug reactions in that...
diseases and are effective in tackling the symptoms. An example of the target disease is ischemic heart disease. Some examples of commonly prescribed drugs for...
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