DRESS syndrome associated with the consumption of allopurinol: case report
DOI:
https://doi.org/10.52379/mcs.v7i2.282Keywords:
Erythroderma, Pharmacoderma, Allopurinol, DRESS syndromeAbstract
DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) represents a severe pharmacoderma with different clinical and paraclinical manifestations secondary to a drug hypersensitivity reaction. Its exact incidence is unknown but it is estimated between 1 in 1,000 and 1 in 10,000 cases of exposure to associated drugs. It is characterized by extensive generalized dermatosis in conjunction with organic involvement, lymphadenopathy, eosinophilia, and atypical lymphocytosis. Commonly associated drugs include aromatic anticonvulsants, carbamazepine, sulfonamides, and allopurinol. By using the RegiSCORE score it is possible to confirm or rule out a suspected diagnosis. Treatment depends on the severity of presentation, including topical steroids up to systemic steroids of variable duration depending on clinical and biochemical response. Mortality rates of 10 to 20% are reported, with liver failure being the main cause of death in these patients. We present the case of a 71-year-old female patient who, after treatment with allopurinol, debuted with erythroderma secondary to DRESS Syndrome.
Downloads
References
Husain Z, Reddy BY, Schwartz RA. DRESS syndrome. Journal of the American Academy of Dermatology. 2013;68(5):693.e1-693.e14. https://doi.org/10.1016/j.jaad.2013.01.033
Waseem D, Latief M, Sofi N, Dar I, Khan Q, Abbas F, et al. Dress Syndrome: A Review and Update. Skin Diseases & Skin Care. 2016;1(1):1–8. URL.
Kardaun SH, Sekula P, Valeyrie-Allanore L, Liss Y, Chu CY, Creamer D, Sidoroff A, Naldi L, Mockenhaupt M, Roujeau JC; RegiSCAR study group. Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. Results from the prospective RegiSCAR study. Br J Dermatol. 2013;169(5):1071-80. https://doi.org/10.1111/bjd.12501
Choudhary S, McLeod M, Torchia D, Romanelli P. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. J Clin Aesthet Dermatol. 2013;6(6):31-7. URL.
Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L, et al. The DRESS Syndrome: A Literature Review. The American Journal of Medicine. 2011;124(7):588–97. https://doi.org/10.1016/j.amjmed.2011.01.017
Chung WH, Chang WC, Stocker SL, Juo CG, Graham GG, Lee MHH, et al. Insights into the poor prognosis of allopurinol-induced severe cutaneous adverse reactions: the impact of renal insufficiency, high plasma levels of oxypurinol and granulysin. Ann Rheum Dis. 2015;74(12):2157–64. https://doi.org/10.1136/annrheumdis-2014-205577
Cho YT, Yang CW, Chu CY. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System. IJMS. 2017;18(6):1243. https://doi.org/10.3390/ijms18061243
Shiohara T, Mizukawa Y. Drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS): An update in 2019. Allergology International.2019;68(3):301–8. https://doi.org/10.1016/j.alit.2019.03.006
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Louis Fernando Robles Fernandes, Myrka Daniela Almeida Cabrera, Erick Escorcia Martinez, Diana Jessica Leyva Tenorio, Evangelina Vargas Villegas
This work is licensed under a Creative Commons Attribution 4.0 International License.