DRESS syndrome caused by efalizumab.
We report a case of drug reaction with eosinophilia and systemic symptoms (DRESS) to efalizumab. A 52-year-old man developed a widespread papulovesicular rash after 4 weeks of treatment with efalizumab (1.0 mg/kg/week) for treatment-resistant severe psoriasis. Histology revealed a subepidermal blister with eosinophil-rich inflammatory cell infiltrate. Subsequently, the patient developed high peripheral eosinophilia, abnormal liver function, malaise and fever, all requiring inpatient admission. Efalizumab was discontinued immediately, but the rash persisted for 4 months and was only controlled by oral prednisolone at a dose of 30 mg/day. To our knowledge, this is the first reported case of DRESS caused by efalizumab.
White
J M L
JM
Skin Therapy Research Unit, St John's Institute of Dermatology, St Thomas' Hospital, London, UK. jonathan.white@gstt.nhs.uk
Smith
C H
CH
Robson
A
A
Ash
G
G
Barker
J N W N
JN
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D003875:Drug Eruptions / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004802:Eosinophilia / Q000139:chemically induced; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy; D013577:Syndrome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; D011239:Prednisolone; C472181:efalizumab