Hematologic Patterns in Differentiating DRESS From Morbilliform Drug Eruptions: A Preliminary Investigation

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) and morbilliform drug eruption (MDE) are 2 distinct drug eruptions that can appear clinically similar at presentation. Given the significant morbidity of DRESS, there is a need for objective markers that can aid in early recognition.Objective: The purpose of this study is to explore the diagnostic potential of routine hematological data on or near the date of rash onset.Methods: We use machine learning as an exploratory method to identify any early hematological patterns capable of differentiating DRESS from MDE.Results: We found that lymphocyte count, pan-immune inflammation value, neutrophil-to-lymphocyte ratio, and platelet levels were strong discriminators of DRESS from MDE at initial presentation.Conclusions: These findings highlight the potential of hematologic profiles to enhance early diagnostic accuracy.