Question 1

What are the most common culprit drugs for DRESS?

Accepted Answer

Aromatic anticonvulsants (carbamazepine, phenytoin, lamotrigine), allopurinol, sulfonamides, dapsone, minocycline, and abacavir. Allopurinol is most common with renal impairment.

Question 2

How does DRESS differ from SJS/TEN?

Accepted Answer

DRESS has longer latency (2–8 weeks vs 5–28 days), prominent eosinophilia and visceral involvement, and less severe epidermal detachment. DRESS requires corticosteroids; SJS/TEN requires supportive care.

Question 3

What is the role of HHV-6 reactivation in DRESS?

Accepted Answer

HHV-6 reactivation occurs in 40–60% of cases 2–4 weeks after onset. It is part of Japanese DIHS criteria but not RegiSCAR. Testing can support the diagnosis.

Question 4

How is DRESS treated beyond culprit drug withdrawal?

Accepted Answer

Systemic corticosteroids (prednisolone 0.5–1 mg/kg/day, slow taper over 6–12 weeks) are mainstay. Cyclosporine or IVIG for refractory cases. Long-term follow-up for autoimmune sequelae.