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DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) or DIHS (Drug-Induced Hypersensitivity Syndrome) is a potentially life-threatening adverse drug-reaction.
Incidence is 1/1,000 to 1/10,00 drug exposures. It occurs 2-6 weeks after the drug is first introduced, distinguishing it from other adverse drug-reactions which typically occur sooner.
The syndrome classically includes:
- Severe skin eruptions (typically morbilliform or erythrodermic eruptions)
- Hematologic abnormalities (eosinophilia or atypical lymphocytosis)
- Organ involvement; e.g., hepatic (most common), pneumonitis, renal failure, etc.
- Fevers
- Arthralgia
- Lymphadenopathy
The most commonly implicated drugs are anticonvulsants (e.g., carbamazepine, phenobarbital, and phenytoin), sulfonamides, and allopurinol.
Recovery is typically complete after discontinuing the offending drug; systemic steroids may promote resolution of the illness.
References
Cacoub P. et al. The DRESS syndrome: a literature review. Am J Med 2011 Jul;124(7):588-97. http://www.ncbi.nlm.nih.gov/pubmed/21592453
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