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Case Reports
. 2024 Jul 8;16(7):e64061.
doi: 10.7759/cureus.64061. eCollection 2024 Jul.

A Dermatological Dilemma: The Importance of Recognizing Dermatologic Manifestations of Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) in Skin of Color Patients

Nadim A Qadir  1 , Christopher Marsalisi  1 , Anvit D Reddy  1 , Luke Stachler  1 , Nirmal Onteddu  1
Affiliations
Case Reports

A Dermatological Dilemma: The Importance of Recognizing Dermatologic Manifestations of Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) in Skin of Color Patients

Nadim A Qadir et al. Cureus. .

Abstract

Many dermatologic conditions that are seen in medical literature are typically on lighter skin tones making it easier to identify. This can pose a difficult problem in the care of skin of color patients. The purpose of this paper is to highlight the importance of dermatologic manifestations in skin of color patients and the disparities that exist in the medical field. Here, we present the case of a 51-year-old African American male who was hospitalized on a prolonged course of antibiotics found to have drug reaction with eosinophilia and systemic symptoms (DRESS). Although the initial diagnosis was not made at symptom onset due to the atypical presentation in darker skin tones, the patient improved when the diagnosis was eventually made with cessation of the offending agent and steroid therapy. There is a vital need for continued awareness of the disparities that exist within medical literature and the medical field in regard to skin of color patients.

Keywords: african american; dermatology; dress; drug induced hypersensitivity syndrome; drug reaction with eosinophilia and systemic symptoms; skin of color; vancomycin-induced dress syndrome.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. MRI axial T2-weighted sequence of the lower abdomen which reveals a small abscess within the left psoas (arrow), with adjacent muscular edema. There is also minimal muscular edema within the right psoas muscle.
MRI: magnetic resonance imaging
Figure 2
Figure 2. Sagittal MRI with STIR sequence demonstrating mild vertebral body edema at the L3 and L4 levels concerning for discitis-osteomyelitis (arrow).
MRI: magnetic resonance imaging; STIR: short tau inversion recovery
Figure 3
Figure 3. Coalescing white facial rash with skin sloughing.
Figure 4
Figure 4. Morbilliform rash on the right upper extremity.
Figure 5
Figure 5. Periorbital and lip swelling seen.
Figure 6
Figure 6. Line graph illustrating the trend of WBC count and eosinophils since offending agent onset.
WBC: white blood cell
See this image and copyright information in PMC

References

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    1. Complicated drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome history in a 14-year-old. Tomani M, Caridi C, Tatarina-Nulman O, Charlot C, Narula P. Am J Case Rep. 2021;22:0. - PMC - PubMed
    1. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome in childhood: a narrative review. Manieri E, Dondi A, Neri I, Lanari M. Front Med (Lausanne) 2023;10:1108345. - PMC - PubMed
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