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Characterizing DRESS syndrome recurrence: a systematic review
Ajay N Sharma1, Samantha Shwe1, Vignesh Ravi2
1Department of Dermatology, University of California, Irvine, CA , USA.
Archives of Dermatological Research
|September 10, 2021
Summary
DRESS syndrome recurrence is not well understood. New medications often trigger relapse, and viral reactivation or organ involvement worsens prognosis. Dermatologists must manage patients carefully to minimize risk.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome recurrence is poorly characterized.
- Dermatologists require better understanding for patient prediction, identification, and management.
- Limited data exists on recurrence patterns and prognostic factors.
Purpose of the Study:
- To characterize the recurrence of DRESS syndrome.
- To identify common triggers, clinical features, and outcomes of recurrent DRESS syndrome.
- To provide insights into managing DRESS syndrome recurrence.
Main Methods:
- A primary literature search was conducted using PubMed.
- Included all articles reporting cases of DRESS syndrome recurrence.
- Analyzed 42 articles comprising 60 patients.
Main Results:
- Average age of patients was 46.3 years; average time to recurrence was 123 days.
- Recurrences often presented with higher fever and peak eosinophils, frequently triggered by new medications.
- Viral reactivation (HHV-6) and liver involvement were common complications; survival rate was 71% in available cases.
Conclusions:
- Viral reactivation, severe organ involvement, and hematological abnormalities indicate a poorer prognosis.
- Treatment should continue until normalization, with slow tapering to reduce relapse risk.
- Further research is needed to refine prediction and management strategies for DRESS syndrome recurrence.
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