Drug rash with eosinophilia and systemic symptoms (DRESS): changing carbamazepine to phenobarbital controlled epilepsy without the recurrence of DRESS.
We report a case of drug rash with eosinophilia and systemic symptoms (DRESS) due to carbamazepine. Anticonvulsants are the most common medicines causing DRESS and once it occurs, it is difficult to find an effective alternative treatment. In our case, switching from carbamazepine to phenobarbital successfully controlled both the DRESS and the convulsions. A positive patch test indicates the major role of delayed type allergy in the pathogenesis of this syndrome. Although reactivation of some viruses has been reported, their pathogenic role was not confirmed in our case.
Inadomi
Toru
T
Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, 173-8610, Tokyo Japan. inadomy@med.nihon-u.ac.jp
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects*; D003587:Cytomegalovirus / Q000276:immunology; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D004802:Eosinophilia / Q000139:chemically induced*; D004827:Epilepsy / Q000188:drug therapy; D005334:Fever / Q000139:chemically induced; D015654:Herpesvirus 6, Human / Q000276:immunology; D016199:Herpesvirus 7, Human / Q000276:immunology; D006801:Humans; D008297:Male; D010328:Patch Tests; D010634:Phenobarbital / Q000627:therapeutic use; D013577:Syndrome
D000914:Antibodies, Viral; D000927:Anticonvulsants; D002220:Carbamazepine; D010634:Phenobarbital