title: Therapeutic management of DRESS: a retrospective study of 38 cases.
abstract: BACKGROUND
  There is no consensus regarding treatment for drug reaction with eosinophilia and systemic symptoms (DRESS).
  
  
  OBJECTIVE
  We report a single-center observational series of therapeutic management of DRESS.
  
  
  METHODS
  We examined data for 50 consecutive patients admitted from March 2005 to June 2009 with a discharge diagnosis of DRESS (RegiSCAR score).
  
  
  RESULTS
  For the 38 patients with a DRESS score of 4 or more, topical steroid treatment alone was initiated in 66% of cases. On admission, 13 patients received systemic steroids; in 7 of them, systemic steroid treatment was initiated or maintained for life-threatening organ failure, with kidney, lung, and/or nervous system involvement. Complications of DRESS, such as relapse, viral reactivation, and sepsis, were less frequent with topical steroid than with systemic steroids. None of the patients died during their stay in hospital.
  
  
  CONCLUSIONS
  Retrospective nonblinded design and dermatologic recruitment are limitations. The variables underlying the choice of treatment study were not analyzed.
  
  
  CONCLUSIONS
  Systemic steroids may not be required for the management of mild forms of DRESS, and may thus be reserved for more severe cases. Prospective studies are required to evaluate strategies for treating DRESS.
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France; Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Elisa
authors.initials: E
authors.lastname: Funck-Brentano
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France; Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Tu-Anh
authors.initials: TA
authors.lastname: Duong
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Bouvresse
authors.affiliation: Department of Dermatology, Hôpital Saint Louis, Assistance Publique-Hõpitaux de Paris (AP-HP), Université Paris VII, Sorbonne Paris Cité, Paris, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Bagot
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France; Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Wolkenstein
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France; Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Roujeau
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France; Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chosidow
authors.affiliation: Dermatology Department, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France; Referral Center for Toxic and Autoimmune Diseases, Assistance Publique-Hõpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Université Paris Est Créteil (UPEC), Créteil, France. Electronic address: laurence.allanore@hmn.aphp.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Valeyrie-Allanore
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D013256:Steroids
keywords: drug reaction with eosinophilia and systemic symptoms; drug-induced hypersensitivity syndrome; severe cutaneous adverse reactions; systemic corticosteroids treatment; therapeutic management; topical steroids