Erosive cheilitis as an early manifestation in DRESS syndrome

salha, wahbi ben; Moussaoui, Eya; Oualha, Lamia; Anoun, J.; Douki, Nabiha

doi:10.1002/ccr3.5123

Cited by 3 publications

(1 citation statement)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a prospective case-control study, cyclosporin was associated with a shorter time of cessation of rash progression, rash resolution, and normalization of leukocytosis, eosinophilia, and hepatocellular markers in comparison with a corticosteroid-treated group [ 22 ]. Cyclosporine has a beneficial effect on DRESS syndrome, given its rapid onset of action, and effective inhibition of T cell proliferation and IL-5 production, which is responsible for the development of eosinophilia [ 3 , 23 ]. Kim et al reported a steroid-refractory DRESS case that was treated successfully with the drug tofacitinib.…”

Section: Reviewmentioning

confidence: 99%

Drug-Induced Reaction With Eosinophilia and Systemic Symptoms: A Review

Alotaibi¹

2023

Cureus

View full text Add to dashboard Cite

Drug-induced reaction with eosinophilia and systemic symptoms (DRESS) is a part of severe cutaneous adverse reactions (SCAR), often a life-threatening condition. DRESS is an uncommon reaction; however, it is more prevalent than Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and is left undiagnosed due to its atypical clinical presentation. So far, no standard criteria or investigational tool assists in early and accurate diagnosis. The administration of systemic corticosteroids remains the widely used first line of management. However, new studies have revealed other potential treatment armamentariums. Because of the potential life-threatening outcome, every physician who deals with acute cases should be familiar with the clinical presentation and be able to start the necessary measurements. Recent studies revealed important information in the pathogenesis and management of the disorder were summarized in this review.

show abstract

Section: Reviewmentioning

confidence: 99%

Drug-Induced Reaction With Eosinophilia and Systemic Symptoms: A Review

Alotaibi¹

2023

Cureus

View full text Add to dashboard Cite

show abstract

Allopurinol

2021

Reactions Weekly

View full text Add to dashboard Cite

DRESS syndrome: case reportA 69-year-old woman developed DRESS syndrome during treatment with allopurinol for gout. The woman was referred to a hospital by the internal medicine department due to lesions of the oral mucosa. She had history of type 2 diabetes mellitus (for 17 years), hypertension (for 10 years), gout disease and dyslipidaemia. She had surgical history of cholecystectomy and coronary artery bypass surgery. Her medications included metformin, captopril, glibenclamide, isosorbide dinitrate, fluvastatin, propranolol, colchicine and aspirin. Six week prior to the hospitalization, she started receiving allopurinol [dosage and route not stated] for gout flare-up. A week prior to the hospitalization, she developed fever associated with night sweats, chills and malaise. The next day, she noticed labial oedema and bluish spots on her lower limbs.The woman consulted the emergency department, where she received unspecified symptomatic treatment, but with no improvement. Thereafter, she consulted dermatologist, who treated her with prednisolone. Thereafter, she was referred to the internal medicine department, where she was admitted. On day 1 of admission, she was well-oriented and conscious. Tests revealed body temperature of 38.7°C, pulse rate of 67 beats/minute, BP of 120/70mm Hg and body weight of 72kg. Physical examination revealed confluent erythematous maculopapular rash, which was diffused all over the body (stomach, feet, legs, back and chest), sparing the face, palms, scalp and soles. Auscultation revealed that her chest was clear, and heart had regular rhythm and rate. Remainder of the examination showed no abnormalities. At the department of dental medicine, oral examination demonstrated painful erosive cheilitis, confluent ulcerations on the labial mucosa and crusty lesions on the lips. These findings were similar to those observed in some bullous drug eruption, but her Nikolsky sign was negative. She started receiving amoxicillin to prevent infection of the lesions. Prednisolone, chlorhexidine-based mouthwash and unspecified analgesic were prescribed. Oral biopsy was scheduled. Complete blood count demonstrate WBC of 10.28 × 10 3 /mm 3 with lymphocytes of 9.4%, monocytes of 11.3% and eosinophils of 16.1% (1.65 × 10 3 /mm 3 ), indicating moderate eosinophilia. C-reactive protein was elevated (13 mg/L). Findings for tests for serum electrolytes, sedimentation rate, haematocrit and haemoglobin were normal. Serology for hepatitis C and B and blood and urine cultures were negative. Uric acid and serum triglyceride and glucose were high. Skin biopsy showed a subepidermal inflammatory infiltrate comprising of eosinophils and lymphocytes. Histology was consistent with a toxic drug reaction. Based on her history, biological tests and clinical presentation, she was diagnosed with cutaneous adverse drug reaction. She started receiving treatment with prednisolone. The most likely cause of reaction was thought to be the allergic response to allopurinol. On day 7of admission, alteration in renal function was o...

show abstract

Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases

Dagnon da Silva,

Domingues,

Oluic

et al. 2023

JCM

View full text Add to dashboard Cite

Unlike other adverse drug reactions, visceral organ involvement is a prominent feature of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and correlates with mortality. The aim of this study was to systematically review cases published in PubMed-indexed, peer-reviewed journals in which patients had renal injury during the episode of DRESS syndrome (DS). We found 71 cases, of which 67 were adults and 56% were males. Female sex was associated with higher mortality. Chronic kidney disease (CKD) was present in 14% of patients who developed acute kidney injury (AKI) during DS. In 21% of cases, the kidneys were the only visceral organ involved, while 54% of patients had both liver and kidney involvement. Eosinophilia was absent in 24% of patients. The most common classes of medication associated with renal injury in DS were antibiotics in 34%, xanthine oxidase inhibitors in 15%, and anticonvulsants in 11%. Among antibiotics, vancomycin was the most common culprit in 68% of patients. AKI was the most common renal manifestation reported in 96% of cases, while isolated proteinuria or hematuria was present in only 4% of cases. In cases with AKI, 88% had isolated increase in creatinine and decrease in glomerular filtration (GFR), 27% had AKI concomitantly with proteinuria, 18% had oliguria, and 13% had concomitant AKI with hematuria. Anuria was the rarest manifestation, occurring in only 4% of patients with DS. Temporary renal replacement therapy was needed in 30% of cases, and all but one patient fully recovered renal function. Mortality of DS in this cohort was 13%, which is higher than previously reported. Medication class, latency period, or pre-existing CKD were not found to be associated with higher mortality. More research, particularly prospective studies, is needed to better recognize the risks associated with renal injury in patients with DS. The development of disease-specific biomarkers would also be useful so DS with renal involvement can be easier distinguished from other eosinophilic diseases that might affect the kidney.

show abstract

Erosive cheilitis as an early manifestation in DRESS syndrome

Cited by 3 publications

References 33 publications

Drug-Induced Reaction With Eosinophilia and Systemic Symptoms: A Review

Drug-Induced Reaction With Eosinophilia and Systemic Symptoms: A Review

Allopurinol

Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases

Contact Info

Product

Resources

About