Dress Syndrome

Dress Syndrome


By Dr. Rasya Dixit, Dermatology

The acronym to DRESS is Drug Reaction with Eosinophilia and Systemic Symptoms. This is used to describe a condition that is caused due to the hypersensitive drug reaction.This is often characterized by excessive skin rash, pharyngitis, lymphadenopathy, hepatitis and sometimes the involvement of kidneys, lungs, heart or pancreas.

What are its symptoms ?

The symptoms start showing after three to eight weeks after using the same kind of drug. The symptoms flare up after three to four weeks.These are the symptoms that are often shown by DRESS syndrome

  1. Excessive intake of similar kind of drugs.
  2. Having fever.
  3. Development of rashes.
  4. From mild exanthem to blistering of skins.
  5. Auto-immunity to DRESS.

How to make its diagnosis ?

The complete diagnosis depends upon the type of symptoms present.Although the symptoms are not vivid initially but after having mild symptoms it is compulsory to see a health practitioner.

If DRESS syndrome is suspected, prescribers are reminded to look beyond the skin as the severity and extent of skin involvement does not always correlate with the extent of internal organ involvement.

What risk factors are associated with DRESS?

The most commonly linked medicines with DRESS include the mood stabilizers, anticonvulsants, anti-inflammatory drugs, etc. Mood stabilizers and anticonvulsants are more keen and liable to getting DRESS. Although the symptoms are shown after few weeks, too much intake of these drugs would lead to severity of this disease causing blisters and cracks on the skin. The major risks would lead to severity in diseases such as hepatitis, diabetes and kidney impairment.

How to get it treated?

Treatments associated with DRESS:

  1. The first and foremost treatment include the removal of drug that is causing DRESS.
  2. The patient should be kept in burn units if DRESS has affected the skin for appropriate care.
  3. If the patient is having fever, It should be treated as quickly as possible with appropriate use of drugs.
  4. Clinical trials may be used to check the severity of DRESS and how to deal with them.
  5. Steroids are recommended for skin burns.

The use of systemic corticosteroids in patients with any sign of severity including: transaminases greater than five times normal, renal involvement, pneumonia, hemophagocytosis, or cardiac involvement is recommended.