Viral Reactivation in Hospitalized DRESS Patients

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• In this retrospective review of 36 inpatients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, the rates of herpes virus reactivation were measured. The rates of viral reactivation at the time of DRESS diagnosis were 10% (CMV), 4% (EBV), 0% (HHV-6), and 0% (HHV-7).

• Based on this study, findings of viral reactivation at the time of DRESS diagnosis are rare events. While HHV-6 reactivation is a diagnostic criterion in some assessments of DRESS, use of these tests for diagnosis or risk stratification is unlikely to be of clinical value.

– Margaret Hammond, MD

Abstract 

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a medication induced hypersensitivity condition common in the hospital setting. Studies conducted in Asia show that herpes viruses can reactivate 2-4 weeks after the initial DRESS diagnosis in up to sixty percent of cases 1-3. HHV-6 reactivation is a diagnostic criteria in some validation assessments 3. Viral reactivation can be used to stratify disease severity and risk of recurrence 1 but the utility of such tests during the initial hospitalization in the United States is unclear.

Journal of the American Academy of Dermatology

Viral Reactivation in Hospitalized DRESS Patients: A Retrospective Study From a Tertiary Medical Center in the United States

J Am Acad Dermatol 2020 Apr 05;[EPub Ahead of Print], N Milani-Nejad, J Trinidad, BH Kaffenberger

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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