DRESS syndrome diagnostic criteria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Serge Korjian M.D.

Overview

There is no gold standard for the diagnosis of DRESS syndrome. Two diagnostic criteria have been proposed: The RegiSCAR criteria and the Japanese Consensus Group criteria.

Diagnostic Criteria

There is no gold standard for the diagnosis of DRESS syndrome.
Two diagnostic criteria have been proposed:

The RegiSCAR criteria^[1]
The Japanese Consensus Group criteria^[2]

The following table illustrates the diagnostic criteria for the diagnosis of DRESS syndrome based on the RegiSCAR criteria and the Japanese consensus group criteria:

RegiSCAR inclusion criteria for DRESS syndrome At least three of the four starred criteria are required for diagnosis	Japanese Consensus Group diagnostic criteria for DRESS/DIHS syndrome A total of Seven criteria needed for the diagnosis of typical DRESS/DIHS syndrome / the first five criteria are required for the diagnosis of atypical DRESS/DIHS syndrome
Acute Rash*	Maculopapular rash > 3 weeks following administration of drug
Fever > 38 °C*	Prolonged clinical symptoms 2 weeks following the discontinuation of the suspected drug
Lymphadenopathy in at least two sites*	Fever > 38 °C
Involvement of at least one internal organ*	Liver function test abnormalities (ALT > 100 U/L) or other organ involvement
Hospitalization	Leukocyte abnormalities
Reaction suspected to be drug-related	Leukocytosis ( > 11 x 10⁹/L)
Blood count abnormalities (lymphopenia or lymphocytosis, eosinophilia, thrombocytopenia)	Atypical lymphocytosis (>5%)
	Lymphadenopathy
	Human herpesvirus 6 reactivation

References

↑ Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. (2007). “Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?”. Response Br J Dermatol. 156 (3): 609–610. doi:10.1111/j.1365-2133.2006.07704.x. PMID 17300272.
↑ Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. (2007). “The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations”. Response Br J Dermatol. 156 (5): 1045–92. doi:10.1111/j.1365-2133.2007.07807.x. PMID 17381452.

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[Kardaun-1] Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. (2007). “Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?”. Response Br J Dermatol. 156 (3): 609–610. doi:10.1111/j.1365-2133.2006.07704.x. PMID 17300272.

[Shiohara-2] Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. (2007). “The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations”. Response Br J Dermatol. 156 (5): 1045–92. doi:10.1111/j.1365-2133.2007.07807.x. PMID 17381452.

[1]

[2]

DRESS syndrome diagnostic criteria

Overview

Diagnostic Criteria

References

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