Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris Groupe Hospitalo-Universitaire de l'Est Parisien (HUEP), Assistance Publique Hôpitaux de Paris (APHP), Paris, France Sorbonne Universités, Paris, France; Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), INSERM U1135, Paris, France.
Service de Dermatologie, Hôpital Hôtel Dieu, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France.
J Am Acad Dermatol. 2020 Mar;82(3):606-611. doi: 10.1016/j.jaad.2019.09.036. Epub 2019 Sep 25.
Diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS) is challenging. Some clinicians reject this diagnosis when the delay of onset is less than 15 days after drug intake.
To assess the delay of DRESS occurrence and culprit drugs.
All patients hospitalized in 3 dermatology departments with a first occurrence of DRESS for which a drug was highly suspected were included in this retrospective study. Based on the delay in DRESS occurrence, cases were classified into 2 groups: a rapid-onset group (≤15 days after exposure) and a delayed-onset group (>15 days).
A total of 41 patients with DRESS were included: 14 in the rapid-onset and 27 in delayed-onset groups. In the rapid-onset group, antibiotics (n = 6/14) and iodinated contrast media (n = 5/5) were the predominant culprits. Carbamazepine (n = 4/4), lamotrigine (n = 6/6), allopurinol (n = 8/8), and sulfasalazine (n = 2/2) were exclusively found in the delayed-onset group.
The retrospective nature, limited number of participants, and lack of detailed information on previous exposure to sensitizing drugs in some instances.
DRESS is frequently related to drugs introduced 15 or fewer days before the occurrence of cutaneous adverse reactions. The time of onset of DRESS may differ depending on the medications involved.
药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）的诊断具有挑战性。一些临床医生在药物摄入后 15 天内发病时会拒绝诊断这种疾病。
评估 DRESS 发病的延迟时间和致病药物。
本回顾性研究纳入了在 3 个皮肤科部门首次发生 DRESS 的所有患者，这些患者的药物高度可疑。根据 DRESS 发病的延迟时间，将病例分为 2 组：快速发作组（暴露后≤15 天）和迟发组（＞15 天）。
共纳入 41 例 DRESS 患者：快速发作组 14 例，迟发组 27 例。在快速发作组中，抗生素（n=6/14）和碘造影剂（n=5/5）是主要的致病药物。卡马西平（n=4/4）、拉莫三嗪（n=6/6）、别嘌醇（n=8/8）和柳氮磺胺吡啶（n=2/2）仅在迟发组中发现。
本研究为回顾性研究，参与者数量有限，在某些情况下缺乏关于致敏药物先前暴露的详细信息。
DRESS 常与皮肤不良反应发生前 15 天或更短时间内使用的药物有关。DRESS 的发病时间可能因所涉及的药物而异。
