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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a medical condition that involves a major reaction to certain medications, after a patient has been using a given medication for a prolonged amount of time. Diagnosis can be complicated not only by the length of time before symptoms appear, but because the symptoms themselves are similar to other systemic conditions. Symptoms may include eosinophilia, or high white blood cell count, fever, rash, the inflammation of some organs, and swollen lymph nodes.
Treatment for DRESS syndrome, after it has been identified, often involves limiting the damage caused by the inappropriate immune response. Systemic corticosteroid drugs are generally used as a front line treatment. These medications suppress the immune function throughout the entire body through preventing the release of compounds, known as phospholipids, that are involved in the immune system's inflammatory response. Suppressing inflammation results in reduced pain, fever, and swelling, so these drugs can rapidly reduce symptoms of DRESS syndrome.
The long-term impact of corticosteroids on DRESS syndrome treatment remains unknown. This is due to the fact that doctors often only use these drugs when this medical condition is life-threatening, and only for short periods of time. Other treatments with fewer side effects are often used for controlling this syndrome.
A safer course of treatment with fewer side effects such as a compromised immune system may be obtained through the use of multiple drugs. Skin-related symptoms of DRESS syndrome, such as rashes, itching, and swelling, may be alleviated by the use of topical creams containing corticosteroids. As the steroids do not reach the blood stream with this treatment, the potential for widespread side effects decreases. Local antiseptics may be used to treat any open sores or areas of scabbing.
DRESS syndrome can be controlled for longer periods of time through the use of interferon cc. This naturally-occurring compound is used by the body to limit or stop immune reactions. Few cases of interferon cc's use in long-term treatment have been recorded in the scientific literature surrounding this condition, so its use may carry risks that have not been fully evaluated yet.
Flow sheets and records of drugs administered to a patient are vital in determining which compound led to the onset of DRESS syndrome. Through the process of elimination and the time of syndrome onset, doctors may be able to single out the offending culprit quickly. Skin tests, particularly using substances that are more likely to cause this syndrome, may also be employed. Upon pinpointing the drug causing this reaction, doctors can remove it from a patient's medication regimen, treating the condition and preventing it from returning, in most cases.