[Drug reaction with eosinophilia and systemic symptoms]

Cutaneous drug eruptions are delayed type hypersensitivity reactions that can be potentially life threatening. Severe cutaneous adverse reactions encompass the acute generalized exanthematous pustulosis (AGEP), the drug reaction with eosinophilia and systemic symptoms (DRESS), the Stevens-Johnson syndrome (SJS) and the toxic epidermal necrolysis (TEN, synonym: Lyell syndrome). In this article, we focus on the DRESS syndrome, which associates skin eruption and systemic symptoms. Its mortality rate is estimated at 10%. Therefore early diagnosis and the interruption of the culprit drug are crucial. In this review, we discuss the physiopathology, the most common eliciting drugs, the diagnostic criteria and the proposed treatments of DRESS.