Characteristics of patients hospitalized for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) at a Level 1 trauma center.

The purpose of this study is to further characterize the population that is hospitalized for a severe cutaneous drug reaction or that developed once during their hospitalization. We conducted a chart review of patients seen by a dermatologist at the University of California Davis Medical Center for the diagnosis of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Between January 2000 and July 2018, 25 cases of DRESS were diagnosed using RegiSCAR criteria. Twenty-two patients recovered, two were deceased, and one was transferred to another hospital. The most commonly implicated drugs in the development of DRESS were nafcillin (N=3) and carbamazepine (N=3). Of the 25 patients in our care, 88% developed eosinophilia, 50% developed renal involvement, and 44% had liver involvement. There was a positive correlation between age and creatine (P=0.01) and age and eosinophils (P=0.02). There was a negative correlation between age and liver enzyme abnormalities (AST P=0.01; ALT P=0.0003). Carbamazepine and nafcillin were commonly implicated drugs in DRESS. There was no significant difference between treatment group and patient outcome. Those who develop DRESS at an older age were more likely to have elevated creatinine and more profound eosinophilia, but were less likely to develop liver involvement.