DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)

Overview

DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome is a complex, broad spectrum syndrome with clinical manifestations that appear 2 ~ 8 weeks after introduction of the offending agent.

Clinical Presentation

Fever
Eosiniphilic rash: urticaria, maculopapular eruption (vesicles, bullae, purpura, pustules)
Eosinophilic leukocytosis
Pancytopenia
Abnormal liver function tests
Visceral involvement

Hepatitis, pneumonitis, myocarditis, pericarditis, nephritis, and colitis.

Mortality Estimate

~ 10%

Medications reported to trigger DRESS

Antimicrobials

Dapsone
Minocycline
Penicillin
Sulfamethoxazole/Trimethoprim
TB antimicrobials

Antiepileptic drugs

Phenytoin
Phenobarbital

Allopurinol
NSAIDs

See: Choudhary S, McLeod M, Torchia D, Romanelli P. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. The Journal of Clinical and Aesthetic Dermatology. 2013;6(6):31-37.