Drug reaction with eosinophilia and systemic symptoms (DRESS) may occur within two weeks of drug exposure: a retrospective study

Abstract Background Diagnosing DRESS is challenging. Some clinicians reject this diagnosis when the delay of onset is less than 15 days after drug intake. Objectives To assess the delay of DRESS occurrence and culprit drugs. Methods All patients with a 1st occurrence of DRESS hospitalized in 3 dermatology departments, for which a drug was highly suspected were included in this retrospective study. Based on the delay in DRESS occurrence, cases were classified into two groups: a rapid-onset group (≤15 days after exposure) and a delayed-onset group (>15 days). Results 41 patients with DRESS were included; 14 in the rapid-onset and 27 in delayed-onset groups. In the rapid-onset group, antibiotics (n = 6/14) and iodinated contrast media (n = 5/5) were the predominant culprits. Carbamazepine (n = 4/4), lamotrigine (n = 6/6), allopurinol (n = 8/8) and sulfasalazine (n = 2/2) were exclusively found in the delayed-onset group. Limitations The retrospective nature, the limited number of subjects, and lack of detailed information on previous exposure to sensitizing drugs in some instances. Conclusions DRESS is frequently related to drugs introduced ≤15 days before the occurrence of cutaneous adverse reactions. The time of onset of DRESS may differ depending on the medications involved.