Descamps V, Ben Saïd B, Sassolas B, Truchetet F, Avenel-Audran M, Girardin P, Guinnepain M-T, Mathelier-Fusade P, Assier H, Milpied B, Modiano P, Lebrun-Vignes B, Barbaud A
Hôpital Bichat, AP-HP, Paris, France.
Ann Dermatol Venereol. 2010 Nov;137(11):703-8. doi: 10.1016/j.annder.2010.04.024. Epub 2010 Aug 5.
The management of drug-induced hypersensitivity syndrome or drug reaction with eosinophilia and systemic symptoms (DRESS) is not codified. Demonstration of the reactivation of Herpesviruses illustrates the specific pathophysiology of this syndrome. Proposals for the management of DRESS were elaborated by the cutaneous adverse drug reaction working group of the French Society of Dermatology to help with its management.
From a review of literature and the experience of the members of this group, consensual proposals were written about diagnostic criteria, tests, treatment options, and follow-up. These proposals will need to be validated in prospective studies.
A decisional tree of treatment options is proposed, based on the severity of visceral manifestations. The importance of a rapid withdrawal of the culprit drug and of a long-term follow-up is underlined. Treatment will be adapted to the clinicobiological status (topical corticosteroid, systemic corticosteroid, intravenous gammaglobulins, antivirals).
药物性超敏反应综合征或伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）的管理尚无规范。疱疹病毒再激活的证明阐明了该综合征的具体病理生理学。法国皮肤病学会皮肤药物不良反应工作组制定了DRESS的管理建议，以协助其管理。
通过回顾文献和该组成员的经验，就诊断标准、检查、治疗选择和随访撰写了共识性建议。这些建议需要在前瞻性研究中得到验证。
根据内脏表现的严重程度，提出了治疗选择的决策树。强调了迅速停用致病药物和长期随访的重要性。治疗将根据临床生物学状态进行调整（局部皮质类固醇、全身皮质类固醇、静脉注射免疫球蛋白、抗病毒药物）。
