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What Is DRESS Syndrome?

An individual experiencing fever for several weeks after taking a new prescription may have DRESS syndrome.
A person with DRESS syndrome will experience a widespread skin rash.
Hypersensitivity to medication refers to DRESS syndrome.
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  • Written By: Erin J. Hill
  • Edited By: C. Wilborn
  • Last Modified Date: 03 August 2014
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DRESS syndrome stands for drug rash (or reaction) with eosinophilia and systemic symptoms. Also known as drug hypersensitivity syndrome, it refers to a condition noted by hypersensitivity to certain medications. This condition is often severe, and it can result in death if not diagnosed early.

A patient who is experiencing DRESS syndrome may first notice a fever one to eight weeks after beginning a new drug regime. Drug exposure may be prolonged or brief, and the progression of the syndrome will vary from patient to patient. After the fever, many patients experience a widespread skin eruption that may be long lasting, and which may progress to exfoliative dermatitis. Organ damage may soon follow. Symptoms involving the internal organs can include hepatitis, nephritis, myocarditis, or pneumonitis, which can be life threatening.

Any patient who has begun taking, or has taken, a new medication and experiences prolonged fever and skin rashes should contact a medical professional immediately. Blood tests to rule out DRESS syndrome should be done as soon as possible. It is important for a patient to receive treatment while the illness is still in its early stages.

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Interactions between medications is a common link in DRESS syndrome. The main categories of prescriptions linked to this condition include anticonvulsants carbamzepine, phenytoin, and phenobartitone. Specific medications that are most commonly linked to the condition can include, but are not limited to, atenolol, carbamazepine, dapsone, oxicam NSAIAs, and sulphasalazine. Patients who have experienced symptoms in the past should not take the medications and should practice extreme care if taking them becomes unavoidable.

The exact cause of DRESS syndrome is currently unknown. One possible cause is a malfunction in the body’s ability to filter toxins properly through the lymphatic system. This could result in a toxic overload that may result in the condition. Studies conducted to determine possible causes have been limited, and have focused mainly on determining the specific types of medications most to blame for the side effects. There is a possible genetic predisposition to this syndrome, and patients who have immediate family members who have suffered from it should alert their healthcare provider before taking any high risk medications.

Treatment for DRESS syndrome includes stopping all doses of the suspected medication causing the symptoms. Keeping the symptoms under control until the body can properly detoxify itself is key to survival. In some patients, systemic steroids have proven beneficial. It is often necessary to continue treatment for several weeks, while watching for a relapse after symptoms have ceased.

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Discuss this Article

anon963718
Post 10

I was misdiagnosed as having mono and turned out I had Dress syndrome, I was hospitalized for seven weeks and had multi-organ failure and was intubated due to the severity. I feel that most doctors in the U.S. lack knowledge on DRESS Syndrome. They have yet to figure out which medication caused the initial reaction.

anon356861
Post 9

As frustrating as it is, you will eventually get completely over it. It took me three or four months for the rash/hives to completely resolve. Each time I tapered the steroid dose, I would break out into hives and rash for a few days (none of the major initial symptoms).

My doctor decided to taper into half pills and quarter pills at the end, which helped out a lot. It stinks, but you have to be patient. Best of luck to you.

anon346618
Post 8

I had DRESS and was misdiagnosed as having a virus. It took me two urgent care visits, one doctor visit, two ER visits and a hospital transfer to get it diagnosed. After a week in the hospital, four days of it in the ICU, they sent me home with steroids, now almost a month later, I just finished the steroids and the rash is coming back! Wish me luck with getting over this.

anon316854
Post 7

I lost a workmate to this condition. He had fever, seizures, loss of thought, generalised body rash, and even loss of conscious. He was using tegretol to control seizures.

anon314080
Post 6

I was diagnosed with DRESS after taking Bactrim for about four weeks. At first, I thought that I had the flu with a constant fever, aches, and pains. After about two weeks, I broke out in severe rashes all over, had failing liver and kidneys, and gained over 30 pounds in fluid.

Fortunately, the ER that I drove myself to transferred me to a higher level medical facility. Foolishly, I had never related my symptoms to the Bactrim earlier. It took over three months to fully recover.

anon312962
Post 5

I was diagnosed with DRESS and Steven's - Johnson Syndrome. I had symptoms of both. I had neurological problems like my legs could not move at first. I could not swallow. The skin on my feet sloughed off, and the lining of my mouth,esophagus, and stomach were like a really raw sore throat. I also experienced the worse imaginable joint pain and skin pain. I wished to die it was so bad. Without excellent physician care and physical therapy, speech therapy and pain control, I would not have made it.

anon301388
Post 4

I was hospitalized for two weeks and diagnosed as having Stephen Johnson syndrome. I actually had DRESS. The doctors and staff at the hospital seemed to lack knowledge on this (and SJS).

I was not able to get a dermatology consult, which would have been very beneficial to my case. The offending drug for me was either Cymbalta or carbamazepine.

anon280761
Post 3

My son at 17 years of age was diagnosed with DRESS syndrome. At first, the doctors thought it was mono, but after weeks of suffering and another week of hospital stay in an ICU unit, they found it was this DRESS syndrome caused by Lamictal and Bactrin.

If it had been for our persistence in his getting his condition properly diagnosed, the outcome would have been much worse.

aaaCookie
Post 2

Unfortunately, the increase in recent years of hasty diagnoses and drug prescriptions, especially multiple drugs at the same time, has led to more people than ever who have some sort of allergy or reaction to a drug or drugs that they are taking.

widget2010
Post 1

Acronyms are so weird. I have no idea why they would think to give the acronym of a woman's piece of clothing to something relating to drug or medicine use. While I imagine it made sense at the time, it's just really odd.

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