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Journal of the American Academy of Dermatology
Volume 72, n° 2
pages 246-252 (février 2015)
Doi : 10.1016/j.jaad.2014.10.032
accepted : 24 October 2014
Original Articles

Therapeutic management of DRESS: A retrospective study of 38 cases
 

Elisa Funck-Brentano, MD a, b, Tu-Anh Duong, MD a, b, Sophie Bouvresse, MD a, Martine Bagot, MD, PhD c, Pierre Wolkenstein, MD, PhD a, b, Jean-Claude Roujeau, MD a, b, Olivier Chosidow, MD, PhD a, b, Laurence Valeyrie-Allanore, MD a, b,
a Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France 
b Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France 
c Department of Dermatology, Hôpital Saint Louis, Assistance Publique-Hõpitaux de Paris (AP-HP), Université Paris VII, Sorbonne Paris Cité, Paris, France 

Reprint requests: Laurence Valeyrie-Allanore, MD, Service de Dermatologie, 51 avenue du Maréchal de Lattre de Tassigny, Hôpital Henri-Mondor, F-94010 Créteil Cedex, France.
Abstract
Background

There is no consensus regarding treatment for drug reaction with eosinophilia and systemic symptoms (DRESS).

Objectives

We report a single-center observational series of therapeutic management of DRESS.

Methods

We examined data for 50 consecutive patients admitted from March 2005 to June 2009 with a discharge diagnosis of DRESS (RegiSCAR score).

Results

For the 38 patients with a DRESS score of 4 or more, topical steroid treatment alone was initiated in 66% of cases. On admission, 13 patients received systemic steroids; in 7 of them, systemic steroid treatment was initiated or maintained for life-threatening organ failure, with kidney, lung, and/or nervous system involvement. Complications of DRESS, such as relapse, viral reactivation, and sepsis, were less frequent with topical steroid than with systemic steroids. None of the patients died during their stay in hospital.

Limitations

Retrospective nonblinded design and dermatologic recruitment are limitations. The variables underlying the choice of treatment study were not analyzed.

Conclusions

Systemic steroids may not be required for the management of mild forms of DRESS, and may thus be reserved for more severe cases. Prospective studies are required to evaluate strategies for treating DRESS.

The full text of this article is available in PDF format.

Key words : drug-induced hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms, severe cutaneous adverse reactions, systemic corticosteroids treatment, therapeutic management, topical steroids



 Dr Funck-Brentano is currently affiliated with the Department of Dermatology, Hôpital Ambroise Paré, Boulogne-Billancourt, France.
 Funding sources: None.
 Conflicts of interest: None declared.



© 2014  American Academy of Dermatology, Inc.@@#104156@@