Atypical presentation of DRESS/DiHS mimicking an acquired ichthyosis: A case report of bortezomib-induced severe erythroderma in multiple myeloma.

We present a case of severe and atypical Drug Reaction with Eosinophilia and Systemic Symptoms/Drug-induced hypersensitivity Symptoms (DRESS/DiHS), also known as DiHS, in a 46-year-old Chinese woman, triggered by bortezomib (Velcade), a proteasome inhibitor, commonly used for the treatment of multiple myeloma. Bortezomib-induced DRESS/DiHS syndrome is rare, with this being the second case documented in the literature. The patient presented with severe erythroderma with ichthyosis-like features, hypereosinophilia, and liver injury. Initial response to high dose of solumedrol was followed by relapses upon switching to oral prednisone. Ultimately, the patient responded to dupilumab and maintained complete remission.