Rolón Marian, Barros Mateo, Ortiz Clara, Cruz Romero Sergio Danilo, Álvarez Johanna
Pathology and Laboratories Department, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Faculty of Medicine, Universidad de Los Andes, Bogotá, Colombia.
Case Rep Dermatol. 2024 Oct 8;16(1):221-225. doi: 10.1159/000541046. eCollection 2024 Jan-Dec.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, drug-induced adverse reaction characterized by skin eruptions, lymphadenopathy, fever, and a broad range of other bodily manifestations. The spectrum of histopathologic and clinical presentations is wide; therefore, DRESS syndrome can mimic other diseases.
We present a case of a 4-year-old male patient who started chemotherapy with vincristine, cytarabine, and etoposide. The first clinical signs were fever, hemodynamic in-stability, and maculopapular erythema. Biopsies of skin lesions were taken, and hyperkeratosis, focal parakeratosis, acanthosis with slight spongiosis, and intraepithelial dyskeratotic cells were observed. There was a perivascular lymphoid infiltrate with abundant eosinophils in the dermis, and eosinophil permeations to the acrosyringium and epithelium were found.
DRESS syndrome is a drug-induced reaction that shares histopathological findings in skin biopsies with those seen in graft-versus-host disease. Although the histological findings are non-pathognomonic, they were characteristic enough to be of importance in the differential diagnosis.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）综合征是一种潜在的危及生命的药物诱导不良反应，其特征为皮疹、淋巴结病、发热以及一系列其他身体表现。组织病理学和临床表现的范围很广；因此，DRESS综合征可能会模仿其他疾病。
我们报告一例4岁男性患者，他开始使用长春新碱、阿糖胞苷和依托泊苷进行化疗。最初的临床症状为发热、血流动力学不稳定和斑丘疹性红斑。对皮肤病变进行了活检，观察到角化过度、局灶性角化不全、棘层肥厚伴轻度海绵形成以及上皮内异常角化细胞。真皮中有血管周围淋巴细胞浸润，伴有大量嗜酸性粒细胞，并且发现嗜酸性粒细胞渗透到汗腺导管和上皮。
DRESS综合征是一种药物诱导反应，其皮肤活检的组织病理学发现与移植物抗宿主病所见相同。尽管组织学发现并非特异性的，但它们具有足够的特征性，在鉴别诊断中具有重要意义。
