DRESS Drug Reaction with Eosinophilia and Systemic Symptoms THE SHORT VERSION: - Drug-induced hypersensitivity reaction o Antiepileptics and allopurinol- Life threatening- Look for: o Rash (morbiliform) o Diffuse lymphadenopathy o Diffuse facial edema (ask the pt as this may not be obvious on exam and something they forget to mention) o Visceral involvement - Liver (typically mild, can be severe liver failure) - Kidneys (check Cr and BUN) - Lungs (hypoxemia, pneumonitis, pleural effusion)- Typically resolves in weeks after offending agent is removed- Treat supportively (if renal/lung involvement consider corticosteroids) THE LONG VERSION THAT YOU LIKELY WONT REMEMBER AND WILL HAVE TO LOOK UP WHEN YOU SEE A PATIENT WITH DRESS: - Drug-induced hypersensitivity reaction - Life threatening o 80% drug related o Occurs 2-8 weeks after initiation of medication o Antiepileptic agents (eg, carbamazepine, lamotrigine, phenytoin, phenobarbital) and allopurinol are the most frequently reported causes o 10-20% a drug relationship cannot be established - Look for: 1
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A group of Syrian men wearing their traditional clothes Photo credit: Ruby Goes Photo credit: Arian Zwegers THE GULF When it comes to the Gulf it is pretty easy to spot its citizens as, differently from most other countries in the region, they have kept wearing their traditional clothes
