DRESS SYNDROME- 07/06/16

Most commonly implicated drugs

1)Anti-seizure medications- Phenytoin, Carbamazepine, Lamotrigine etc.
2)Allopurinol
3)Sulfa drugs

Timing

Usually symptoms start 2-8 weeks after exposure (much later than SJS/TEN)

Systemic Symptoms 

Fever, Malaise, Lymphadenopathy, Morbilliform eruption
Mucosal involvement less common than TEN/SJS
Facial edema in 50 % of cases

Lab abnormalities

Leukocytosis with eosinophilia (usually >700 microL)
Atypical lymphocytosis
Increased LFT, proteinuria, and any organ system can be involved

Treatment

Discontinue the offending drug!
Solumedrol 1 g/kg if organ involvement (evidence is limited)

DRESS syndrome and other drug eruptions