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DRESS syndrome — SCE Acute Medicine MCQ

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HardAcute Rheumatological and Dermatological EmergenciesDRESS syndromeSCE Acute Medicine

Five weeks after starting carbamazepine, a 48-year-old man develops fever, facial oedema, a widespread morbilliform eruption, lymphadenopathy, eosinophils 2.1 × 10⁹/L, ALT 640 IU/L and AKI. There are no mucosal erosions. Which syndrome best unifies the latency and multisystem injury?

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Correct answer: C — DRESS syndrome with hepatic involvement

The delayed onset, facial oedema, diffuse eruption, eosinophilia, lymphadenopathy and internal-organ injury are characteristic of DRESS. Stop carbamazepine immediately, document the severe drug reaction and assess hepatic, renal, cardiac and pulmonary involvement. The absence of mucosal erosions and epidermal detachment argues against SJS/TEN.

Reference: https://www.gov.uk/drug-safety-update/carbamazepine-oxcarbazepine-and-eslicarbazepine-potential-risk-of-serious-skin-reactions