Diffuse Skin Rash and Mucosal Lesions

  • Marzieh Tavakol


  • Recrudescence of the members of herpesvirus family (HHV6, HHV7, EBV, CMV) and parvovirus B19 is commonly associated with drug reaction with eosinophilia and systemic symptoms (DRESS)

  • Stevens-Johnson syndrome (SJS) is usually accompanied by Mycoplasma pneumonia

  • A crucial, primary step in management of a patient with SJS is discontinuation of the responsible drug

  • A patient with SJS should be treated as a patient with burn-wound and aggressive fluid and electrolytes balance should be exerted

  • Special wound care and ophthalmologic care are recommended, but not application of local antibiotics


Drug reaction with eosinophilia and systemic symptoms Stevens-Johnson syndrome Carbamazepine Herpesvirus 


  1. 1.
    Welch JL, Holland D. What elements suggest infectious mononucleosis? Ann Emerg Med. 2018;71(4):521–2.CrossRefGoogle Scholar
  2. 2.
    Cho Y-T, Yang C-W, Chu C-Y. Drug reaction with eosinophilia and systemic symptoms (DRESS): an interplay among drugs, viruses, and immune system. Int J Mol Sci. 2017;18(6):1243.CrossRefGoogle Scholar
  3. 3.
    Choudhary S, McLeod M, Torchia D, Romanelli P. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. J Clin Aesthet Dermatol. 2013;6(6):31–7.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Karmacharya P, Poudel DR, Pathak R, Donato AA, Ghimire S, Giri S, Aryal MR, Bingham CO. Rituximab-induced serum sickness: a systematic review. In: Seminars in arthritis and rheumatism, vol. 3. Philadelphia: Elsevier; 2015. p. 334–40.Google Scholar
  5. 5.
    Verma R, Vasudevan B, Pragasam V. Severe cutaneous adverse drug reactions. Med J Armed Forces India. 2013;69(4):375–83.CrossRefGoogle Scholar
  6. 6.
    Duong TA, Valeyrie-Allanore L, Wolkenstein P, Chosidow O. Severe cutaneous adverse reactions to drugs. Lancet. 2017;390(10106):1996–2011.CrossRefGoogle Scholar
  7. 7.
    Schneider JA, Cohen PR. Stevens-Johnson syndrome and toxic epidermal necrolysis: a concise review with a comprehensive summary of therapeutic interventions emphasizing supportive measures. Adv Ther. 2017;34(6):1235–44.CrossRefGoogle Scholar
  8. 8.
    Dean L. Carbamazepine therapy and HLA genotypes. In: Medical genetics summaries. Bethesda: National Center for Biotechnology Information; 2015.Google Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Marzieh Tavakol
    • 1
    • 2
  1. 1.Non-communicable Diseases Research CenterAlborz University of Medical SciencesKarajIran
  2. 2.Department of Allergy and Clinical Immunology, Shahid Bahonar HospitalAlborz University of Medical SciencesKarajIran

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