Department of Dermatology and Venereology, Govt Medical College, Kozhikode, Kerala, India.
Indian J Dermatol Venereol Leprol. 2014 May-Jun;80(3):221-8. doi: 10.4103/0378-6323.132249.
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug reaction which can mimic a viral infection, an autoimmune disease or a neoplastic disease.
To study the clinical and epidemiological aspects of DRESS and to identify the precipitating drugs.
All patients admitted to the dermatology ward of our tertiary care hospital from 1 st October 2010 to 30 th September 2013 with probable or definite DRESS as per the RegiSCAR scoring system were included in this prospective study. The clinical manifestations observed in the study population were studied and the common offending drugs were identified.
During the 3 year study period, 26 patients fulfilled criteria for probable or definite DRESS. In more than 50% of cases, the culprit drug was phenytoin. Most common symptoms observed were fever, rash and facial edema. Liver was the most common internal organ affected. Most of the patients responded to withdrawal of the drug and administration of steroids for 3-6 weeks. One patient with dapsone-induced DRESS died.
Intense facial erythema and edema and an elevated eosinophil count were not found to be bad prognostic factors. In most instances the flare ups during the course of the disease could be managed with a slower tapering of steroids. More prospective studies on DRESS are required to assess the prognostic factors and to formulate better diagnostic criteria.
药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）是一种严重的药物反应，可模仿病毒感染、自身免疫性疾病或肿瘤性疾病。
研究 DRESS 的临床和流行病学特征，并确定诱发药物。
本前瞻性研究纳入了 2010 年 10 月 1 日至 2013 年 9 月 30 日期间因疑似或明确 DRESS 而入住我们三级保健医院皮肤科病房的所有患者。研究人群中观察到的临床表现，并确定常见的致病药物。
在 3 年的研究期间，26 例患者符合可能或明确 DRESS 的标准。在超过 50%的病例中，罪魁祸首药物是苯妥英钠。最常见的症状是发热、皮疹和面部水肿。肝脏是最常见的受影响的内部器官。大多数患者对停用药物和 3-6 周的类固醇治疗有反应。1 例因使用氨苯砜引起 DRESS 的患者死亡。
剧烈的面部红斑和水肿以及嗜酸性粒细胞计数升高并不是不良预后因素。在大多数情况下，疾病过程中的发作可以通过较慢地减少类固醇来控制。需要更多的前瞻性研究来评估 DRESS 的预后因素，并制定更好的诊断标准。
