Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

  • Sylvia H. Kardaun


Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed, potentially life-threatening, hypersensitivity reaction characterized by a widespread, long-lasting skin eruption, fever, lymphadenopathy, hematological abnormalities, and organ involvement. Time to onset and course are relatively long; relapses may occur. Clinical and biological variability make DRESS a challenging diagnosis. Pathogenesis is not exactly known, but probably reflects a complex interplay of drug and viral-related factors in which genetics and abnormal metabolic pathways of drugs play an important role. Although associated with many drugs, DRESS is mainly observed after a limited number of “high risk” drugs. Early recognition, prompt withdrawal of the culprit, and treatment with corticosteroids are the mainstay of management.


DRESS Drug hypersensitivity Eosinophilia Systemic symptoms Multi-organ involvement Viral reactivation HHV-6 



Antiepileptic drugs


Cutaneous adverse drug reactions




Drug (induced) hypersensitivity syndrome


Drug reaction with eosinophilia and systemic symptoms


Herpes virus type 6


Lymphocyte toxicity assay


Lymphocyte transformation test


Maculopapular exanthema



Funding sources: None

Conflict of interest: None


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Sylvia H. Kardaun
    • 1
  1. 1.Department of DermatologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands

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