Thank you Dr. Danny Jimenez for a great presentation on a patient with DRESS secondary to Phenytoin use!

Teaching Points:

• Drug Reaction with Eosinophilia and Systemic Symptoms (morbilloform rash + eosinophilia 50-90%; atypical lymphocytosis 30-70%; elevated LFTs 80%; +fevers; +lymphadenopathy)
• Common Culprit Meds: Antiepileptics, Sulfasalazine, Allopurinol, Vancomycin
• RegiSCAR scoring system helps classify signs/symptoms of DRESS into subcategories of likelihood: exclude; possible; probable; definite
• Tx: STOP offending agent; supportive care; systemic steroids only in patients with severe renal or pulmonary invovlement
• Super helpful table: American Family Physician_Fever and Rash