DRESS

 Q: All of the following are components of DRESS syndrome EXCEPT? 

 A Fever 

B) Eosinophilia 

C) Monocytosis 

D) Skin rash

E) Organ involvement

Answer: C

DRESS syndrome stands for drug reaction with eosinophilia and systemic symptoms (DRESS). Criteria to diagnose DRESS syndrome is mostly based on clinical and laboratory grounds. Score includes 

• Fever 
• Enlarged lymph nodes - at least two different body sites 
• Eosinophilia 
• Atypical lymphocytes 
• Skin involvement 
• Organ involvement 
• Resolution takes more than 15 days 

A value between -1 and 2 is assigned to each feature. 

Score:

• less than 2: Excluded 
• 2 to 3: Possible 
• 4 to 5: Probable 
• 6 or above: Definite

It also requires exclusion of other causes such as HAV, HBV, HCV, mycoplasma, chlamydia, ANA, and negative blood cultures. 

 #pharmacology

References:

1. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol 2007; 156:609. 

2. Kardaun SH, Sekula P, Valeyrie-Allanore L, et al. Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. Results from the prospective RegiSCAR study. Br J Dermatol 2013; 169:1071.