Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS):A Review of 21 Cases over 7 years Period from Selayang Hospital
- Author:
Sook Yee Michelle Voo
;
Luk Chin Wong
;
Hui Wen Ng
;
Rohna Ridzwan
- Publication Type:Original Article
- Keywords:
severe cutaneous adverse drug reaction, maculo-papular rash, acute liver failure, eosinophil
- From:Malaysian Journal of Dermatology
2017;38(June):57-64
- CountryMalaysia
- Language:English
-
Abstract:
Introduction:
DRESS is an uncommon severe cutaneous adverse drug reaction, which is under recognized. In this
review, we aim to study the clinical characteristics of patients with DRESS that presented to our
hospital.
Methods:
We conducted a retrospective analysis on the data of all the patients with DRESS from January 2006
to December 2012 in Selayang Hospital.
Results:
Twenty-one patients were included with median age of 33 and male to female ratio of 1:1. Allopurinol
was the most frequent causative drug followed by anti-tuberculous drugs. The mean latency period
was 28.6 days. All patients had macula-papular rash of which 6 progressed to erythroderma. Liver was
the most frequent extra cutaneous organ involvement with median peak alanine transaminase of 746
iu/l, (range 45-3677) and median peak aspartate transaminase of 632 iu/l (range 30-3136). Six patients
(28.5%) had acute liver failure. The mainstay of treatment was systemic corticosteroid. Mortality rate
was 23.8%.
Conclusion:
DRESS is a severe cutaneous adverse drug reaction with a myriad of clinical presentation and is
associated with mortality. Our series has higher mortality compared to most other reported studies,
most probably due to referral bias. Early recognition is crucial.
