Drug rash with eosinophilia and systemic symptoms (DRESS): changing carbamazepine to phenobarbital controlled epilepsy without the recurrence of DRESS

Abstract

We report a case of drug rash with eosinophilia and systemic symptoms (DRESS) due to carbamazepine. Anticonvulsants are the most common medicines causing DRESS and once it occurs, it is difficult to find an effective alternative treatment. In our case, switching from carbamazepine to phenobarbital successfully controlled both the DRESS and the convulsions. A positive patch test indicates the major role of delayed type allergy in the pathogenesis of this syndrome. Although reactivation of some viruses has been reported, their pathogenic role was not confirmed in our case.