Case Of Drug Rash Research Articles

A Case of Drug Rash with Eosinophilia and Systemic Symptoms Associated with Valproic Acid and Olanzapine Treatment in Patient with Bipolar Disorder

A Case of Drug Rash with Eosinophilia and Systemic Symptoms Associated with Valproic Acid and Olanzapine Treatment in Patient with Bipolar Disorder

Dermatological side‐effects of telaprevir‐based triple therapy for chronic hepatitis C in phase III trials in Japan

Telaprevir-based triple therapy is highly effective for chronic hepatitis C. However, concern has been expressed over the high frequency and severity of its dermatological side-effects compared with those associated with peginterferon (PEG-IFN) and ribavirin (RBV) therapy. Thus, here, we evaluated the dermatological adverse reactions of telaprevir-based triple therapy in Japanese multicenter phase III clinical trials in an attempt to characterize the dermatological side-effects and establish appropriate management plans. In these trials, 126 treatment-naïve patients and 141 treatment-failure patients were administrated telaprevir, PEG-IFN-α-2b and RBV for 12weeks followed by PEG-IFN-α-2b and RBV for another 12weeks (T12/PR24 group), and 63 treatment-naïve patients were administrated PEG-IFN-α-2b and RBV for 48weeks (PR48 group). Dermatological adverse reactions developed in over 80% patients in both groups, and most of them were grade 1 or 2. In the T12/PR24 group, there were more grade 2 or grade 3 events, and the time to onset was earlier than that in the PR48 group. Most reactions could be managed with topical corticosteroids and oral antihistamines, and the rates of discontinuation due to dermatological reactions were not high even in the T12/PR24 group. In the T12/PR24 group, however, two cases of Stevens-Johnson syndrome and one case of drug rash with eosinophilia and systemic symptoms, which corresponds to drug-induced hypersensitivity syndrome in Japan, were reported. For appropriate treatments of individual dermatological adverse reactions, the judgment of discontinuation of antiviral drugs and treatment based on the severity are extremely important in this triple therapy.

A case of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) related to rufinamide

Drug Rash (or Reaction) with Eosinophilia and Systemic Symptoms (DRESS) is a potentially life-threatening hypersensitivity reaction to drugs characterized by rash, fever, lymphadenopathy, hematologic abnormalities, and involvement of internal organs. Initially coined in 1996, the term is used to refer to an idiosyncratic reaction to several drugs, the most common of which are carbamazepine, allopurinol, sulfasalazine, and phenobarbital. We report the first case of DRESS related to rufinamide in a ten year old boy with a history of a complex seizure disorder.

A case of drug rash with eosinophilia and systemic symptoms (DRESS) syndrome complicating airway management

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe multi-system reaction defined by fever, rash, eosinophilia, and internal organ involvement. The condition typically occurs one to eight weeks following exposure to inciting medications. In severe cases, it can develop into multi-organ system failure and death. We present a case of DRESS syndrome with mucosal edema that led to extreme difficulties with airway management. A 65-yr-old male treated for an esophageal perforation with broad-spectrum antibiotics developed fever, eosinophilia, and extensive rash consistent with DRESS syndrome. This condition resulted in a rapid progression to multi-organ system dysfunction, severe hemodynamic instability, and the need for high-dose vasopressors and tracheal intubation. Extensive mucous membrane involvement led to significant complications with airway management and a nearly impossible tracheal intubation, features in the disease not previously described. With the airway secure, initiation of steroids resulted in regression of the disease within 24hr, resolution of airway edema, and uneventful tracheal extubation a few days later. We emphasize the need for early identification of DRESS syndrome as well as the possible airway implications associated with this increasingly recognized clinical entity.

Case of drug rash with eosinophilia and systemic symptoms induced by zonisamide and reactivation of human herpes virus 7

Case of drug rash with eosinophilia and systemic symptoms induced by zonisamide and reactivation of human herpes virus 7

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.

Hydroxychloroquine-induced DRESS syndrome

The authors describe the first case of drug rash with eosinophilia and systemic symptoms syndrome caused by hydroxychloroquine treatment in a male patient affected by seronegative arthritis.