DRESS (drug reaction with eosinophilia and systemic symptoms): a possible prolonged course with sequelae

DRESS (drug reaction with eosinophilia and systemic symptoms) is a rare but potentially severe drug-induced hypersensitivity reaction that can lead to multiple organ failure. One of the characteristics of DRESS is its potential for persistent progression, even without reintroduction of the culprit drug or introduction of another molecule with a risk of cross-reaction. The mechanisms of these "long" or "chronic" DRESS reactions are not elucidated, but several mechanisms may involve immunological or viral factors or dependence to corticosteroids, which remains the current standard of care. It is important to be aware of this evolving risk, which has a major impact on patient management. In addition, DRESS can sometimes lead to serious long-term complications, such as autoimmune disorders or sequelae due to organ failure secondary to DRESS or its treatment. These complications need to be detected early and avoided as much as possible through early diagnosis and the treatment of patients.