Drug rash with eosinophilia and systemic symptoms

Drug rash with eosinophilia and systemic symptoms (DRESS) is a syndrome reflecting a marked hypersensitivity reaction to drugs or medications.

Clinical presentation can be variable and symptoms may arise from 2 to 8 weeks after initiating the offending drug. Typical clinical features include skin rash, fever, lymph node enlargement, and internal organ involvement. In terms of internal organ involvement, it most commonly involves the liver followed by the kidneys and lungs.

The pathophysiology of DRESS syndrome is not well known. Many drug have been be known to cause precipitation of this syndrome and includes

  • anticonvulsants
  • sulfonamides
  • dapsone
  • allopurinol
  • minocycline
  • gold salts

CT chest is often non-specific but may be represented by diffuse multifocal infiltrative opacification 5.

The prognosis can be variable but can carry a mortality of up to ~10% in patients with multi-organ involvement. Withdrawal of the causative drug and steroid therapy as traditionally been a mainstay of treatment. 

It was first described in 1996 by Bocquet et al 1.

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Article information

rID: 41036
System: Vascular, Chest
Synonyms or Alternate Spellings:
  • Drug reaction with eosinophilia and systemic symptoms
  • Drug hypersensitivity syndrome
  • Drug hypersensitivity syndrome (DHS)
  • Drug rash with eosinophilia and systemic symptoms (DRESS)

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