Title your presentation “Noon Conference”
Prevents inadvertently giving away the case.
Registry of Severe Cutaneous Adverse Reactions (RegiSCAR)
Chest radiograph or CT scan may provide evidence of interstitial pneumonitis and/or pleural effusion. Drug-specific CD8+ T lymphocytes and eosinophils may be found in broncho-alveolar lavage fluid
Other organs — Several other organs can be involved in DRESS, including [10]:
●Heart (eosinophilic myocarditis, pericarditis)
●Gastrointestinal tract (diarrhea, mucosal erosions, bleeding)
●Pancreas (pancreatitis)
●Thyroid (autoimmune thyroiditis, appearing often late, as a sequel of DRESS)
●Brain (encephalitis, meningitis)
●Muscle (myositis, increase in creatine kinase)
●Peripheral nerves (polyneuritis)
●Eye (uveitis)
The initial laboratory evaluation in a patient suspected to have DRESS is aimed at confirming the diagnosis, excluding other conditions that mimic DRESS, and evaluating the extent and severity of visceral involvement (table 3). Laboratory tests include:
Diagnosis of SJS/TEN requires clinicopathologic correlation. The appropriate clinical findings include targetoid and atypical targetoid skin lesions and at least two mucosal surfaces involved (ocular, oral, genital, etc.).3,5 Nikolsky's sign, which refers to epidermal detachment occurring with lateral pressure adjacent to bullae, is present and can be a clue to diagnosis. In patients with these appropriate clinical findings, a lesional skin biopsy should be performed to confirm the diagnosis and rule out other possible entities, including staphylococcal scalded skin syndrome, generalized fixed drug eruption, and drug-induced linear IgA bullous dermatosis.7 Lesional biopsies reveal full thickness epidermal necrosis with minimal dermal inflammation
Skin Biopsy-mild spongiosis and a lymphocytic infiltrate in the superficial dermis, predominantly perivascular, with eosinophils and dermal edema,
Etanercept trial of 91 People was associated with a shorter time to complete skin healing and lower mortality rate compared with intravenous prednisolone [1]. Serious adverse events, including sepsis, respiratory failure, and upper gastrointestinal bleeding were less frequent in the etanercept group.
