DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS): A COMPREHENSIVE REVIEW

Clelia K. B.*, Prathvi M. V. and A. R. Shabaraya

ABSTRACT

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare but severe drug-induced hypersensitivity reaction with high morbidity and potential mortality if not promptly identified and managed. It is characterized by a triad of skin eruptions, systemic organ involvement, and hematologic abnormalities such as eosinophilia, DRESS syndrome presents a diagnostic challenge due to its variable presentation and delayed onset after drug exposure. This comprehensive literature review synthesizes findings on the epidemiology, pathogenesis, clinical manifestations, diagnostic criteria, and therapeutic strategies associated with DRESS syndrome. The review includes three pairs of basic pathophysiological pillars that underlie DRESS, a systemic illness, encompass: (1) inciting stimuli, including drugs; including anticonvulsants, antibiotics, antivirals, antidepressants etc. (2) genetic factors, such as ethnic predisposition with specific human leukocyte antigens (HLA); and CYP Polymorphisms (3) viral factors, or the reactivation of herpes virus family members, such as Epstein Barr Virus (EBV), cytomegalovirus (CMV), human herpes virus 6 (HHV-6), and HHV-7. Additionally, the literature highlights diagnostic tools like the RegiSCAR criteria and examines current management practices. Early detection and prompt suspension of the offending medicine are the most crucial measures to stop the disease from getting worse. This study focuses on corticosteroid use, alternative immunosuppressive therapies and the use of JAK inhibitors.

Keywords: DRESS syndrome, RegiSCAR criteria, corticosteroid, JAK inhibitors.