Dermatological emergency in pediatrics, DRESS syndrome
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Abstract
Skin reactions induced by drugs in pediatrics are rare entities; However, these are associated with great morbidity and mortality. The DRESS syndrome or drug reaction with eosinophilia and systemic involvement is one of the most representative but little diagnosed due to its low frequency.
Case summary: female minor infant was admitted for postseptal cellulitis which requires vancomycin management, who had clinical deterioration, fever and maculopapular rash with erythematous disseminated background, unmodulated shock, edema, elevation of aminotrasferasas, prolonged clotting times and hypoalbuminemia; Eosinophilia of 8400 and impaired hepatic function, which completed clinical criteria for Dress syndrome. The evolution of the patient was satisfactory, without relapse of rash or fever, she was managed with skin support and hydration treatment, with satisfactory resolution and evolution.
Conclusions: The diagnosis of Dress, despite being exclusionary, should be considered in all children with prior exposure to high-risk medications, may be associated with complications in the acute stage, and despite a good long-term prognosis, it can be associated with complications such as autoimmune diseases, chronic renal or hepatic involvement which should be evaluated as part of ambulatory followup by the pediatrician.
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References
2. Choudhary S, McLeod M, Torchia D, Romanelli P. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. J Clin Aesthet Dermatol. 2013;6(6):31-7.
3. Shiohara T, Kano Y. Drug reaction with eosinophilia and systemic symptoms (DRESSDress): incidence, pathogenesis and management. Expert Opin Drug Saf. 2017;16(2):139-47.
4. Belver MT, Michavila A, Bobolea I, Feito M, Bellón T, Quirce S. Severe delayed skin reactions related to drugs in the paediatric age group: A review of the subject by way of three cases (Stevens-Johnson syndrome, toxic epidermal necrolysis andDRESS). Allergol Immunopathol (Madr). 2016;44(1):83-95.
5. Descamps V. Diagnosis of DRESS (drug reaction with eosinophilia and systemic symptoms) in the intensive care unit: essential but challenging. Shock. 2013;40(5):437-8.
6. Fernando SL. Drug-reaction eosinophilia and systemic symptoms and drug-induced hypersensitivity syndrome. Australas J Dermatol. 2014;55(1):15-23.
7. Kardaun SH, Sekula P, Valeyrie-Allanore L, Liss Y, Chu CY, Creamer D, 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(5):1071-80.
8. Kimmoun A, Dubois E, Perez P, Barbaud A, Levy B. Shock state: an unrecognized and underestimated presentation of drug reaction with eosinophilia and systemic symptoms. Shock. 2013;40(5):387-91.
9. Mattoussi N, Ben Mansour A, Essadam L, Guedri R, Fitouri Z, Ben Becher S. Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome in Children: A Case Report. J Investig Allergol Clin Immunol. 2017;27(2):144-6.
10. Sultan SJ, Sameem F, Ashraf M. Drug reaction with eosinophilia and systemic symptoms: manifestations, treatment, and outcome in 17 patients. Int J Dermatol. 2015;54(5):537-42.
11. Han SH, Hur MS, Youn HJ, Roh NK, Lee YW, Choe YB, et al. Drug Reaction with Eosinophilia and Systemic Symptom Syndrome Induced by Lamotrigine. Ann Dermatol. 2017;29(2):206-9.
12. Johnson S, Mathews S, Hudnall SD. Human herpesvirus 6 lymphadenitis in drug rash with eosinophilia and systemic symptoms syndrome: a lymphoma mimic. Histopathology. 2017;70(7):1166-70.
13. Koca T, Akcam M. Ibuprofen induced DRESS Syndrome in a Child. Indian Pediatr. 2016;53(8):745.
14. Picard M, Fernandez MI, Des Roches A, Bégin P, Paradis J, Paradis L, et al. Ceftazidime-induced drug reaction with eosinophilia and systemic symptoms (DRESS) complicated by hemophagocytic lymphohistiocytosis. J Allergy Clin Immunol Pract. 2013;1(4):409-12.
15. Tonekaboni SH, Jafari N, Chavoshzadeh Z, Shamsian BS, Rezaei N. DRESS Syndrome Presents as Leukoencephalopathy. Turk J Pediatr. 2015;57(5):541-4.