Asian Journal of Research in Dermatological Science

Severe form of Dress Syndrome Treated with Bolus Corticotherapy

J. B. Ntihebuwayo *

Department of Dermatology, CHU Ibn Rochd, Hassan II University, Casablanca, Morocco.

F. Hali

Department of Dermatology, CHU Ibn Rochd, Hassan II University, Casablanca, Morocco.

F. Z. El Fatoiki

Department of Dermatology, CHU Ibn Rochd, Hassan II University, Casablanca, Morocco.

S. Chiheb

Department of Dermatology, CHU Ibn Rochd, Hassan II University, Casablanca, Morocco.

*Author to whom correspondence should be addressed.

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Abstract

Drug hypersensitivity syndrome or DRESS is a drug reaction with eosinophilia and systemic symptoms. The prescription of systemic corticosteroids has been proposed in case of visceral involvement with the possibility of corticosteroid bolus in the presence of severe signs of DRESS. We report the case of a patient who developed DRESS syndrome two months after taking Mesalazine and fifteen days after taking Sulfasalazine with moderate hepatic impairment which progressed to severe hepatic cytolysis despite the discontinuation of the incriminating treatment and the introduction of low-dose corticosteroid therapy. The administration of bolus corticosteroids for three days followed by oral corticosteroids allowed the control and the clinical and biological improvement of the disease.

Keywords: Toxidermy, Mesalazine, sulfasalazine, hepatic cytolysis, corticosteroid bolus

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