Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening hypersensitivity reaction characterized by skin eruption, fever, hematologic abnormalities, and multiorgan involvement. If unrecognized, this condition may be fatal, with a mortality rate of up to 10%.1 Treatment involves discontinuation of treatment with the culprit drug, supportive care, and in severe eruptions with end-organ dysfunction, systemic immunosuppression with glucocorticoids. However, patients with contraindications to glucocorticoids may benefit from treatment with cyclosporine, a calcineurin inhibitor with anti-apoptotic effects on cytotoxic T cells. Cyclosporine also inhibits production of interleukin-5, which generates eosinophilia and drug-specific T cells that mediate DRESS.2 While cyclosporine represents an alternative treatment for DRESS, little is known about its utility.3,4
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Nguyen E, Yanes D, Imadojemu S, Kroshinsky D. Evaluation of Cyclosporine for the Treatment of DRESS Syndrome. JAMA Dermatol. Published online March 11, 2020. doi:10.1001/jamadermatol.2020.0048
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: