{"data":{"id":"10.6084/m9.figshare.97323.v1","type":"dois","attributes":{"doi":"10.6084/m9.figshare.97323.v1","prefix":"10.6084","suffix":"m9.figshare.97323.v1","identifiers":[],"alternateIdentifiers":[],"creators":[{"name":"Diaz-Cano, Salvador J.","nameType":"Personal","givenName":"Salvador J.","familyName":"Diaz-Cano","affiliation":[],"nameIdentifiers":[{"schemeUri":"https://orcid.org","nameIdentifier":"https://orcid.org/0000-0003-1245-2859","nameIdentifierScheme":"ORCID"}]},{"name":"D Creamer","affiliation":[],"nameIdentifiers":[]},{"name":"E Higgins","affiliation":[],"nameIdentifiers":[]},{"name":"R Morris-Jones","affiliation":[],"nameIdentifiers":[]},{"name":"S Bashir","affiliation":[],"nameIdentifiers":[]},{"name":"S Walsh","affiliation":[],"nameIdentifiers":[]},{"name":"W Bernat","affiliation":[],"nameIdentifiers":[]}],"titles":[{"title":"Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Is cutaneous phenotype a prognostic marker for outcome? A review of clinicopathological features of 27 cases."}],"publisher":"figshare","container":{},"publicationYear":2012,"subjects":[{"subject":"Toxicology"},{"subject":"Medicine"},{"subject":"Immunology"},{"subject":"FOS: Clinical medicine","schemeUri":"http://www.oecd.org/science/inno/38235147.pdf","subjectScheme":"Fields of Science and Technology (FOS)"},{"subject":"FOS: Clinical medicine","subjectScheme":"Fields of Science and Technology (FOS)"}],"contributors":[],"dates":[{"date":"2012-11-12","dateType":"Created"},{"date":"2016-01-11","dateType":"Updated"},{"date":"2012","dateType":"Issued"}],"language":null,"types":{"ris":"DATA","bibtex":"misc","citeproc":"dataset","schemaOrg":"Dataset","resourceType":"Dataset","resourceTypeGeneral":"Dataset"},"relatedIdentifiers":[{"relationType":"IsPreviousVersionOf","relatedIdentifier":"10.6084/m9.figshare.97323","relatedIdentifierType":"DOI"}],"relatedItems":[],"sizes":["0 Bytes"],"formats":[],"version":null,"rightsList":[{"rights":"Creative Commons Attribution 4.0 International","rightsUri":"https://creativecommons.org/licenses/by/4.0/legalcode","schemeUri":"https://spdx.org/licenses/","rightsIdentifier":"cc-by-4.0","rightsIdentifierScheme":"SPDX"}],"descriptions":[{"description":"Introduction: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) describes a heterogenous group of severe adverse reactions to medications. The cutaneous phenotype has a number of guises, accompanied by a variety of systemic features including fever, haematological abnormalities and visceral involvement, most commonly the liver. Clinical markers of prognosis have not been identified.\u003cbr\u003e Methods: We reviewed the clinical features, dermatopathology and outcomes of 27 consecutive cases of DRESS presenting to a single unit. Results: 4 distinct patterns of cutaneous involvement were identified: an urticated papular exanthem (13/27 patients), a morbilliform erythema (3/27), an exfoliative erythroderma (3/27) and an erythema multiforme-like (EM-like) reaction consisting of atypical targets (8/27). All patients mounted a fever, most developed lymphadenopathy (24/27) and a peripheral eosinophilia (25/27) and the most common organ involved was the liver (26/27). Review of dermatopathic features of patients with DRESS demonstrated a superficial spongiotic dermatitis in the majority of cases (16/27). A smaller number of cases showed basal cell vacuolar degeneration and necrotic keratinocytes (9/27). These patients with these biopsy findings more commonly had an erythema multiforme like cutaneous phenotype, and more severe hepatic involvement. 3 patients died, 2 following failed liver transplants. Conclusions: Our series is the first in which a detailed dermatological assessment has been made of consecutive patients presenting with DRESS, and the largest UK series to date. Our results suggest a possible prognostic role of the cutaneous and dermatopathic findings in DRESS in predicting the severity of visceral involvement in this syndrome.","descriptionType":"Abstract"}],"geoLocations":[],"fundingReferences":[],"xml":"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