Angèle Soria1, Claire Bernier2, Gwenaelle Veyrac3, Annick Barbaud4, Etienne Puymirat5, Brigitte Milpied6. 1. Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris Groupe Hospitalo-Universitaire de l'Est Parisien (HUEP), Assistance Publique Hôpitaux de Paris (APHP), Paris, France Sorbonne Universités, Paris, France; Centre d'Immunologie et des Maladies Infectieuses-Paris (Cimi-Paris), INSERM U1135, Paris, France. Electronic address: angele.soria@aphp.fr. 2. Service de Dermatologie, Hôpital Hôtel Dieu, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France. 3. Service de Pharmacologie, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France. 4. Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris Groupe Hospitalo-Universitaire de l'Est Parisien (HUEP), Assistance Publique Hôpitaux de Paris (APHP), Paris, France Sorbonne Universités, Paris, France. 5. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Département de Cardiologie, Paris, France. 6. Service de Dermatologie, Hôpital Saint André, Bordeaux, France.
Abstract
BACKGROUND: Diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS) is challenging. Some clinicians reject this diagnosis when the delay of onset is less than 15 days after drug intake. OBJECTIVES: To assess the delay of DRESS occurrence and culprit drugs. METHODS: All patients hospitalized in 3 dermatology departments with a first occurrence of DRESS for which a drug was highly suspected were included in this retrospective study. Based on the delay in DRESS occurrence, cases were classified into 2 groups: a rapid-onset group (≤15 days after exposure) and a delayed-onset group (>15 days). RESULTS: A total of 41 patients with DRESS were included: 14 in the rapid-onset and 27 in delayed-onset groups. In the rapid-onset group, antibiotics (n = 6/14) and iodinated contrast media (n = 5/5) were the predominant culprits. Carbamazepine (n = 4/4), lamotrigine (n = 6/6), allopurinol (n = 8/8), and sulfasalazine (n = 2/2) were exclusively found in the delayed-onset group. LIMITATIONS: The retrospective nature, limited number of participants, and lack of detailed information on previous exposure to sensitizing drugs in some instances. CONCLUSIONS: DRESS is frequently related to drugs introduced 15 or fewer days before the occurrence of cutaneous adverse reactions. The time of onset of DRESS may differ depending on the medications involved.
BACKGROUND: Diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS) is challenging. Some clinicians reject this diagnosis when the delay of onset is less than 15 days after drug intake. OBJECTIVES: To assess the delay of DRESS occurrence and culprit drugs. METHODS: All patients hospitalized in 3 dermatology departments with a first occurrence of DRESS for which a drug was highly suspected were included in this retrospective study. Based on the delay in DRESS occurrence, cases were classified into 2 groups: a rapid-onset group (≤15 days after exposure) and a delayed-onset group (>15 days). RESULTS: A total of 41 patients with DRESS were included: 14 in the rapid-onset and 27 in delayed-onset groups. In the rapid-onset group, antibiotics (n = 6/14) and iodinated contrast media (n = 5/5) were the predominant culprits. Carbamazepine (n = 4/4), lamotrigine (n = 6/6), allopurinol (n = 8/8), and sulfasalazine (n = 2/2) were exclusively found in the delayed-onset group. LIMITATIONS: The retrospective nature, limited number of participants, and lack of detailed information on previous exposure to sensitizing drugs in some instances. CONCLUSIONS: DRESS is frequently related to drugs introduced 15 or fewer days before the occurrence of cutaneous adverse reactions. The time of onset of DRESS may differ depending on the medications involved.
Authors: A Chaabane; H Ben Romdhane; N Ben Fadhel; N Ben Fredj; H Ammar; N Boughattas; Z Chadly; K Aouam Journal: Eur J Clin Pharmacol Date: 2022-06-20 Impact factor: 3.064