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tashat.bsky.social
Do you know DRESS? Important paper by some of the top experts on this severe adverse, life-threatening drug reaction.
#DRESSsyndrome #delayedreaction
#Dermsky
#Medsky
germhuntermd.bsky.social Ilan Schwartz @germhuntermd.bsky.social · Dec 12
Drug reaction with eosinophilia and systemic symptoms (DRESS 👗)

🍞 + 🧈 topic for internists, frequently encountered in infectious diseases due to association with many antibiotics (see table) and b/c it can mimic infection

Review in @nejm.org #MedSky #DermSky #IDSky

www.nejm.org/doi/full/10....
Clinical Features of DRESS and Other Cutaneous Adverse Reactions. Panel A shows the pleomorphic cutaneous findings associated with drug reaction with eosinophilia and systemic symptoms (DRESS). Panel B shows the morphologic features of cutaneous adverse reactions, including DRESS — erosive and exfoliative changes in a patient with DRESS, a morbilliform eruption concentrated on the torso in a patient with an uncomplicated drug eruption, labial erosions with hemorrhagic crusting in a patient with the Stevens–Johnson syndrome and full-thickness epidermal necrosis with bullae formation and a positive Nikolsky’s sign in a patient with toxic epidermal necrolysis, nonfollicular pustules (1 to 2 mm in diameter) on a background of erythema in a patient with acute generalized exanthematous pustulosis (AGEP), and a patient with severe AGEP with erythroderma, numerous sterile pustules, and lakes of pus. AGEP can also be associated with facial edema and the accentuation of earlobe creases. Select Inflammatory and Immunologic Processes Relevant to DRESS. There are several proposed mechanisms by which drug molecules become antigenic or induce sensitization, leading to an expansion of drug-specific T cells. Both CD4+ and CD8+ T cells play a role in mediating inflammation in DRESS. Type 1 helper T cells (Th1) produce cytokines such as interferon-γ, tumor necrosis factor α (TNF-α), and CXCL10, and type 2 helper T cells (Th2) produce cytokines such as interleukin-5, interleukin-4, and interleukin-13. Interleukin-5 is intimately involved in the recruitment, activation, and survival of eosinophils. Thymus- and activation-regulated chemokine (TARC, or CCL17), which is produced mainly by keratinocytes, dendritic cells (DCs), and Langerhans cells, recruits Th2 cells that express CC chemokine receptor 4 (CCR4). Interleukin-13 can direct DCs toward Th2 polarization and promote TARC production. Group 2 innate lymphoid cells, which are responsive to thymic stromal lymphopoietin (TSLP) and interleukin-33, produce large amounts of interleukin-5 and interleukin-13 as well. The role of viral reactivation in DRESS is not completely understood, but proposed mechanisms include enhanced drug hapten presentation, direct tissue injury, and expansion of virus-specific T cells. Regulatory T cells, which function to hamper immune responses, may proliferate in the early phase of DRESS in response to transforming growth factor-β (TGF-β) and interleukin-10 and promote viral reactivation. In later phases of DRESS, regulatory T cells exposed to inflammatory cytokines such as interleukin-6 may develop a type 17 helper T cell (Th17) phenotype. Some authors have postulated that the proliferation of Th17 cells in the later stages of DRESS could partly explain the risk of autoimmune sequelae after resolution of DRESS. CMV denotes cytomegalovirus, EBV Epstein–Barr virus, and HHV human herpes virus. Common causes of DRESS
December 13, 2024 at 4:24 AM
tashat.bsky.social
Some of the best evidenced-based info on acne treatment right here! @drjohnbarbieri.bsky.social
#DRESSsyndrome
#acnetreatment
drjohnbarbieri.bsky.social John Barbieri, MD, MBA @drjohnbarbieri.bsky.social · Dec 22
Want to learn more about which are the best oral antibiotics for the treatment of acne, including the relative role of doxycycline, minocycline, sarecycline (Seysara), trimethoprim-sulfamethoxazole (Bactrim), amoxicillin, and azithromycin, among others? Check out this video:
youtu.be/RgMXi92UjnQ
What are the best antibiotics for acne | Dermatologist and acne expert explains
YouTube video by John Barbieri, MD
youtu.be
December 23, 2024 at 5:43 AM
tashat.bsky.social
New national guidance on #DRESSsyndrome just published by the French National Diagnosis and Care Protocol (PNDS).
You may come across a DRESS patient in your career — this is extremely valuable information!

www.sciencedirect.com/science/arti....
French national protocol for diagnosis and management of drug reaction with eosinophilia and systemic symptoms (DRESS) in adults and children
www.sciencedirect.com
May 25, 2025 at 12:34 AM
tashat.bsky.social
Join survivors, clinicians & researchers to talk, life-threatening drug reactions like DRESS Syndrome & SJS/TEN.

Aug 9 · 10 AM ET — Reg: ow.ly/EqXf50Wy9FC

Hosted by Vanderbilt University Medical Center.

#dermsky #medsky #immunosky #allergysky #DRESSsyndrome #drugallergy
August 8, 2025 at 7:32 PM
tashat.bsky.social
Join us for an informative DRESS Syndrome Webinar!
Leading experts, patients, and loved ones share insights & stories.

📅 National DRESS Syndrome Day — July 16, 2025 (12–2 PM ET)

🔗 Register & learn more: bit.ly/FacesOfDRESS

#DRESSsyndrome #drugallergy #dermsky #medsky #Immunosky #allergysky #IDsky
July 5, 2025 at 1:29 PM
tashat.bsky.social
“making safe drugs more accessible and making dangerous drugs more safe.” See Dr. Elizabeth Phillips’ interview with Discoveries in Medicine!

#DRESSsyndrome
#SJS
#SCARs

#Dermsky
#Medsky

discoveries.vanderbilthealth.com/2025/01/mult...
Discoveries in Medicine - Multispecialty Center Targets Adverse Drug Reactions
Researchers believe better understanding of adverse drug reactions allows for diagnosis and the chance to provide targeted patient therapies.
discoveries.vanderbilthealth.com
January 11, 2025 at 3:22 AM
dermatologyadvisor.bsky.social
Among hospitalized patients with #DRESSSyndrome, no significant difference occurred in 30-day mortality or discharge rates between those who were initially treated with topical vs systemic #corticosteroids. #DermSky
First-Line Topical Steroids Are Appropriate in Some Adults With DRESS Syndrome
Topical corticosteroids are an appropriate alternative to systemic corticosteroids in some hospitalized adults with DRESS syndrome.
www.dermatologyadvisor.com
June 10, 2026 at 7:24 PM