Drug Reaction with Eosinophilia and Systemic Symptoms <unk>  is a severe adverse drug reaction. The exact pathogenesis of<unk>  is poorly understood, but it is thought that genetic deficiency of detoxifying enzymes, such as epoxide hydrolase deficiency, results in accumulation of toxic metabolites following drug administration and subsequent activation of immunologic reactions. The incidence of<unk>  is approximately 10 to 100 per 100,000 drug exposures with a case-fatality rate of approximately 10%.<unk>  has been reported among patients of all age groups with neither gender nor racial predilection. 
Common symptoms of<unk>  include rash and fever.<unk>  is characterized by a prolonged latency period (2-8 weeks following the administration of triggering drug). If left untreated,<unk>  self-resolves following the discontinuation of the triggering drug in the majority of cases, but clinical manifestations may persist up to 3 months. Complications of<unk>  include visceral organ involvement and development of chronic autoimmune diseases. Common physical examination findings of patients with<unk>  include high-grade fever, diffuse exanthematous eruption (commonly exfoliative dermatitis), lymphadenopathy, facial edema, abdominal tenderness, and hepatomegaly. Laboratory findings of patients with<unk>  usually differ depending on the organ involvement. Common Lab findings include anemia, eosinophilia, atypical lymphocytosis, monocytosis, thrombocytopenia, and elevated anti-HHV6 antibodies (viral reactivation). Drug withdrawal is the first step in the management of<unk> . Supportive care is considered the mainstay of therapy, and hospitalization and administration of pharmacologic agents is usually necessary. Medical therapy for the management of<unk>  usually include topical and/or systemic corticosteroids, antipyretic agents, and symptomatic management of exfoliative dermatitis (fluids, nutritional support, management of electrolyte imbalances, and sepsis prevention).
DRESS syndrome
Arthritis-dermatitis syndrome
Papular purpuric gloves and socks syndrome
Sweet's syndrome
Herxheimer reaction
Stevens-Johnson syndrome
Staphylococcal scalded skin syndrome
Chronic cold urticaria