Abstract:
Importance:Drug-induced hypersensitivity syndrome (DIHS), also known as drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, is a potentially life-threatening reaction to medications with a mortality rate up to 10%. Standard therapy involves the use of systemic corticosteroids with tapering doses extending up to 9 months after the initial reaction. Alternative treatments for DIHS are needed, especially for patients for whom systemic corticosteroids are contraindicated. Objective:To assess a short course of cyclosporine as first-line therapy for DIHS. Design, Setting, and Participants:In this case series, 2 patients referred to the dermatology service of an academic tertiary care hospital and subsequently diagnosed as having DIHS were studied from December 1, 2013, through July 31, 2014. Interventions:Short course (3-7 days) of cyclosporine. Main Outcomes and Measures:Clinical and laboratory indicators were examined to determine the timing and efficacy of cyclosporine treatment. Results:Two cases are reported of drug hypersensitivity reaction that were treated with cyclosporine, resulting in rapid and significant clinical improvement. The first case involved a woman in her 40s who developed DIHS after treatment with carbamazepine. A 7-day course of cyclosporine resulted in clinical resolution of the DIHS. The second case was that of a man in his 30s with minocycline-induced DIHS. A 3-day course of cyclosporine resulted in rapid and sustained clinical improvement. Conclusions and Relevance:A short course of cyclosporine was of therapeutic benefit in the treatment of 2 patients with DIHS. Short courses of cyclosporine in the acute care setting may be an alternative to longer courses of systemic corticosteroids in the treatment of DIHS.
journal_name
JAMA Dermatoljournal_title
JAMA dermatologyauthors
Kirchhof MG,Wong A,Dutz JPdoi
10.1001/jamadermatol.2016.2220subject
Has Abstractpub_date
2016-11-01 00:00:00pages
1254-1257issue
11eissn
2168-6068issn
2168-6084pii
2536059journal_volume
152pub_type
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