To date, no study has identified a clear relationship between drug and a specific clinical presentation of DRESS.

Investigate the particularities of DRESS and analyze the variation of DRESS pattern according to culprit drugs.

We analyzed cases of DRESS notified to the Department of Clinical Pharmacology at the University Hospital of Monastir over a 15-year period. Statistics was performed using comparative and multivariate analysis.

For “anticonvulsive agents”, the occurrence of lymphadenopathies was higher, the renal involvement was rare and mild, and positive skin tests were more frequent. “Allopurinol” group was associated to a higher patients age, a lower occurrence of lymphadenopathies and severe renal impairment. For “antibiotics”, eosinophilia rate was lower, time to recovery was shorter and RegiScar score was weak. The multivariate analysis showed a linkage of allopurinol to severe renal impairment, antibiotics to short latency period and weak RegiScar score and anticonvulsants to high propensity of positive skin test.

We report the largest African and south Mediterranean cohort of DRESS and evaluated the usefulness of skin tests in identifying the culprit drug. The prominent finding was that independently, latency period and renal involvement may differ according to culprit drugs.