When Common Medications Trigger a Rare Reaction: A Review of Clinical Features, Diagnosis, and Treatment Options of DRESS Syndrome

Introduction and purpose: Drug-induced reaction with eosinophilia and systemic symptoms (DRESS) is a severe, life-threatening systemic drug reaction. The challenges in identifying DRESS syndrome result from its symptoms being variable, diverse, and unspecific. Due to the potentially lethal consequence, any clinician should be aware of the symptomatology and be prepared to initiate the appropriate steps. This review summarizes the clinical manifestations and provides essential information on the management of the illness. State of knowledge: DRESS appears to be a rare reaction that frequently remains undetected due to its atypical clinical presentation. Fever, skin rash, lymphadenopathy, eosinophilia, and organ involvement as well as other manifestations, may occur. The onset may be delayed by weeks after exposure to the offending drug. DRESS syndrome is classified as a type IV hypersensitivity. It is thought to be triggered by antiepileptic drugs and antibiotics although many other medications can cause the condition. Certain genetic factors may also predispose some individuals to develop DRESS. Combining clinical and laboratory findings can help confirm the diagnosis. Discontinuation of the offending drug is the fundamental component of treatment such as supportive care including the use of antihistamines and corticosteroids, but recent research has discovered additional promising therapy options. Conclusions: Detecting DRESS syndrome early is crucial to ensure prompt treatment, prevent serious complications, and improve patient outcomes. Healthcare providers should be aware of the signs and symptoms of DRESS syndrome, especially in patients taking particular medications, and be prepared to investigate further if it is suspected.