DRESS Syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms)

An overview of DRESS, including clinical presentation, causative meds, differential diagnosis, treatment, and prognosis.

Image credits:
Morbilliform rash by Heinz F. Eichenwald, in Public Domain
Lungs by Mikael Häggström, in Public Domain
Heart by Bruce Blaus, provided under CC BY-SA 4.0

#eosinophilia #strongmedicine

[viviankrause]

Thank you for sharing your knowledge. My favorite youtube channel! Best regards from a Brazilian nurse.

[JABDUDE]

new graphic style is very cool and makes the video easier to follow.

[AndreeaTrandafirFlagshipMed]

Hi! I'm glad I discovered your channel! I came across this video because yesterday when I was on call I had a similar case. We couldn't exclude an infection, she didn't have eosinophilia, rather lymphocytosis and monocytosis like in a viral infection and we sent the patient to a hospital with infectious disease doctors, dermatologists and many other possibilities to treat the acute patient. I hope she will recover.

[felixgoga]

Thanks again Strong medicine for the DRESS

[sunving]

Thank you Doctor Strong . I learn new thing from you every time.

[Jenw]

DRESS is also 'the gift' that keeps on giving. As if almost a full year on steroids and liver and thyroid damage wasn't enough, I'm STILL on high dose antihistamines a year and a half later. :( I'm lucky to live in a state and medical group known for excellence. Mass General Brigham!

[HuevoBendito]

Very concise and useful, especially for students!

[storytime]

Thank God for you doctors. So many symptoms are the same for so many things. If it wasn't for doctors we would be in a world of hurt.

[_Athos]

My friend's sister just died today due to this. She just scratched an itchy spot and next they knew, she had a fever, then the next thing, she was in ICU and died the next day.

I came here to understand what dress syndrome is as me and my friends are struggling to understand this syndrome. Thank you

[MarcinGomulak]

I'm currently fighting the outcomes of the DRESS due to carbamazepine. I've been in hospital for three weeks. I was on a verge of actually dying. That was horrible. The syndrome attacked my lungs and heart too, but I recovered pretty fast. The steroids were the only meds that actually worked on me and stopped the never ending fever. Right now I'm all itchy, my skin is peeling off. It's month after the treatment, but I'm still fighting it. The showers make the skin burn. It's all awful.
Anyway- the steroids worked, but I've already took them off as lectured by the doctor.

[merwitch]

I currently have this thanks to lamotrigine. I was officially diagnosed few weeks ago. The redness of the rash disappearing but the bumps are still there and it gets VERY itchy and painful at night. I can’t help but scratch and even if water comes in contact with my skin it burns. So obviously baths are painful. My dermatologist put me on steroids now I’m all out and I don’t know what to do but she seems like she’s not taking this seriously. And my employer still expects me to come into work.

[hdeezy]

I believe I have this as I’ve always been healthy and have great skin. Then after a round of antibiotics my entire body broke out with lesions.

[justjeanne]

Great info.! I was so sick all of 2019 with 9 different infections including 2 horrible rashes that looked like the one you showed in this presentation. 7 specialist couldn't determine why I was so sick. Can this happen when a Rx is withdrawn? My 1st rash appeared a couple of weeks after I stopped Xeljanx. The 2nd one appeared a few weeks after 2 loading dose infusions of Simponi Aria. Just curious. Thanks for these videos :).

[mohammadal-drees]

I think I have DRESS. Funnily enough, my surname is Al-Drees.

I’m allergic to *Paroxetine* (some of the generic brands, and I would throw up at times), *Salipax* (it gave me pustules, itching and a dermatitis), *Zoloft* (itching), *Pristiq* (itching), and *Valdoxan* (itch, and moderate-severe bronchitis). I really don’t know what to do at this stage. I’m tired of trying new medications to see if my body will react to them or not. I’m currently living on the highest dose of antihistamine (Telfast + Aerius) every 12 hours. My allergist said that there isn’t a lab test that can identify what I’m allergic to, we covered every test possible.

[sunving]

Thank you very much. I wonder wether cloxacilin could induced DRESS, in Med search only case report.

[dr.derbyallen]

Dr strong, with advent of new superspecialities of medicine such as cardiology, nephro, gastro etc. Etc. Do you feel it's wise to sustain a branch internal medicine or it should be erased ?
Please share your views.

[valentinemcdermott]

Some patients may be taking anticonvulsants, or glucocorticoids and other drugs that would otherwise be tapered before discontinuing them. Would you immediately discontinue those drugs if you suspected them as a cause of DRESS syndrome?

[xaaboopinkly]

Thanks for this great video sir! Is DRESS similar to serositis, which type of hypersensitivity reaction DRESS is?! It’s either type 3 or 4, I’m not sure..

[TheWunder]

I thought this was a video about me for a second.

[belizejuliette]

Hi again, what about Fluoexitin? Elevanse (vyaanse)? My liver is now affected.