Versione Italiana

DRUG-INDUCED HYPERSENSIVITY SYNDROME

Luciano Schiazza M.D.
Dermatologist
c/o InMedica - Centro Medico Polispecialistico
Largo XII Ottobre 62
cell 335.655.97.70 - office 010 5701818
www.lucianoschiazza.it

Drug-induced hypersensivity syndrome (DIHS) also called drug rash with eosinophilia and systemic symptoms (DRESS) is a severe multi-system drug reaction. It can be life-threatening due to the extent of internal organ involvement.

It may occur 2-6/8 weeks after medicine exposure.

Drugs more often reported to cause DIHS:

Diagnostic criteria for DIHS from RegiSCAR study group are (≥ 3 of the criteria marked with an asterisk are required for the diagnosis):

The main and most common features are:

The pathogenesis of DIHS is likely to be multifactorial and include  first of all genetic factors and drug factors. Recently it has been postulated a virus-drug interactions. In fact there is serologic evidence of viral reactivations ( more frequent human herpesvirus 6 but also Epstein-Barr virus, cytomegalovirus, human herpesvirus 7) in DIHS, usually in patients with more severe organ involvement and with a poorer prognosis. But the increase in HHV-6 titres is detectable only late in the course of DIHS and will be helpful only in supporting the diagnosis of DIHS retrospectively.

Treatment consists of: