DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) or DIHS (Drug-Induced Hypersensitivity Syndrome) is a potentially life-threatening adverse drug-reaction.
Incidence is 1/1,000 to 1/10,00 drug exposures. It occurs 2-6 weeks after the drug is first introduced, distinguishing it from other adverse drug-reactions which typically occur sooner.
The syndrome classically includes:
Severe skin eruptions (typically morbilliform or erythrodermic eruptions)
Hematologic abnormalities (eosinophilia or atypical lymphocytosis)
Organ involvement; e.g., hepatic (most common), pneumonitis, renal failure, etc.
Fevers
Arthralgia
Lymphadenopathy
The most commonly implicated drugs are anticonvulsants (e.g., carbamazepine, phenobarbital, and phenytoin), sulfonamides, and allopurinol.
Recovery is typically complete after discontinuing the offending drug; systemic steroids may promote resolution of the illness.
