Drug rash with eosinophilia

Efavirenz can cause an allergic syndrome called the DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms). It is a life-threatening reaction that typically includes a rash, fever, lymphadenopathy, hepatitis, interstitial nephritis, pneumonia, myocarditis, and hematological abnormalities, particularly eosinophi-lia and a mononucleosis-like atypical lymphocjdosis. The DRESS syndrome has been described in an HIV-infected woman taking efavirenz (20). 

Hypersensitivity to barbiturates can result in a life-threatening syndrome called the Drug, Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome with a mortality of 10%. In persons developing hypersensitivity to barbiturates, there is a potential of cross-sensitivity with other aromatic antiepileptics, such as phenytoin and carbamazepine. 

The DRESS syndrome is an acronym for Drug Rash with Eosinophilia and Systemic Symptoms. It is also known as the Drug-Induced Pseudolymphoma and Drug Hypersensitivity Syndrome. The symptoms of DRESS syndrome usually begin I to 8 weeks after exposure to the offending drug. Common causes include carbamazepine, phenobarbital, phenytoin, terbinafine, and valproic acid. 

Bocquet H, Bagot M, Roujeau JC (1996) Drug-induced pseudolymphoma and drug hypersensitivity syndrome (drug rash with eosinophilia and systemic symptoms DRESS). Semin Cutan Med Surg, 15 250-257. 

Drug (-Induced) Hypersensitivity Syndrome (DHS or DiHS) or Drug Rash with Eosinophilia and Systemic Symptoms (DRESS)... 

In one case, drug rash with eosinophilia and systemic symptoms (DRESS) attributed to carbamazepine was successfully managed by switching to phenobarbital [125 ]. 

Skin A man developed overlapping features of drug rash with eosinophilia and systemic symptoms (DRESS), toxic epidermal necrolysis, and Stevens-Johnson syndrome while taking phenytoin [240" ]. A 46-year-old man taking phenytoin developed Stevens-Johnson syndrome, starting in three well-demarcated areas on his scalp, chest, and back, corresponding to ports of... 

Roquin G, Peres M, Lerolle N, Dib N, Mercat A, Crone A, Augusto JF. First report of lamotrigine-induced drug rash with eosinophilia and systemic symptoms syndrome with pancreatitis. Ann Pharmacother 2010 44(12) 1998-2000. 

Ben Fred] N, Aouam K, Chaabane A, Toumi A, Ben Rhomdhane F, Boughattas N, Chakroun M. H5ipersensitiv-ity to amoxicillin after drug rash with eosinophilia and systemic symptoms (DRESS) to carbamazepine and allopurinol a possible co-sensitization. Br J Clin Pharmacol 2010 70(2) 273-6. 

Orbak Z, Sepetcigil O, Karakelleoglu C, Guises S. Penicillin V-induced drug rash with eosinophilia and systemic symptoms. West Indian Med J 2010 59(6) 722-5. 

Tian D, Mohan RJ, Stallings G. Drug rash with eosinophilia and systemic symptoms syndrome associated with clindamycin. Am J Med 2010 123(11) e7-8. 

Rosenbaum J, Alex G, Roberts H, Orchard D. Drug rash with eosinophilia and systemic symptoms secondary to sulfasalazine. J Paediatr Child Health 2010 46 193-6. 

Skin A drug rash with eosinophilia and systemic symptoms (DRESS sjmdrome), a serious adverse drug reaction that causes a maculopapular eruption, facial edema, eosinophUia, and systemic involvement (fever, lymphadenopathy, and abnormal fiver function), has been described in a 34-year-old woman who took propylthiouracil for 6 weeks withdrawal of propylthiomacil and oral glucocorticoid treatment resulted in rapid resolution of symptoms [20 ]. 

A 57-year-old woman developed a drug rash with eosinophilia and systemic symptoms after taking phenylbutazone for 15 days. She had a skin eruption, hypereosinophilia, and liver involvement and made a full recovery after drug withdrawal. 

In one case, facial eczema occurred after titanium dental implantation, with complete remission after removal [84 ]. In another case, drug rash with eosinophilia and systemic symptoms (DRESS) occurred in a previously healthy 19-year-old man after insertion of a titanium bioprosthesis for a spinal fracture [85 ]. 

Skin Drug rash with eosinophilia and systemic symptoms (DRESS) is relatively common in patients taking minocycline, but seems to be much less so in patients taking doxycychne. However, a report has appeared in a 25-year-old woman of African origin who had been taking doxycycline for malaria prophylaxis for 3 weeks [122 ]. 

A 60-year-old woman with polyarthritis taking sulfasalazine developed a drug rash with eosinophilia and systemic symptoms (DRESS) with acute liver failure after taking vancomycin for 2 days [99" ]. After liver transplantation and initial recovery, hepatitis recurred. Lymphocytes and eosinophils were detected post-mortem in the... 

Immunologic There have been further reports of drug rash with eosinophilia and systemic symptoms (DRESS) in patients taking sulfasalazine, a 47-year-old white Brazilian woman who developed DRESS after 8 weeks [104" ], a 60-year-old man with polyarthritis who also developed fulminant liver failure after additional vancomycin treatment [lOS ], and a 68-year-old woman in whom the reaction may have been precipitated by the addition of sulbactam -f ampicillin [lob ll. In another case, drug-induced hypersensitivity syndrome was associated with reactivation of an infection with human herpesvirus-6 in a 15-year-old boy with juvenile rheumatoid arthritis who was taking sulfasalazine [107 ]. 

Skin Dermatological side effects continue to be reported in studies [84 , 86 j and case reports [87, 88, 89 ]. Telaprevir has been associated with drug rash with eosinophilia and systemic symptoms (DRESS) in three cases out of the 56 taking triple therapy at an American medical centre [90 ]. All three cases required discontinuation of therapy. The patients were a 60-year-old man with cirrhosis who had previously failed conventional therapy with peg IFN and RBV, a 55-year-old woman who previously relapsed after peg IFN and RBV treatment, and a 56-year-old female who was a previous nonresponder to peg IFN and RBV. 

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