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Reactive lymphadenopathy in DRESS may show histopathological features of angioimmunoblastic T-cell lymphoma, Hodgkins disease-like pattern, T-cell lymphoma, necrotizing lymphadenitis (Kikuchis disease-like) with or without vasculitis.70,71 Treatment Early recognition of DRESS and immediate withdrawal of the causal medication are essential elements for therapeutic success and mitigation of systemic damage

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may resemble SJS) are typically first signs Usually urticarial, maculopapular eruption In some cases vesicles, bullae, pustules, purpura, target lesions, facial edema, cheilitis, erythroderma +/- lymphadenopathy Systemic involvement may manifest as hepatitis, pneumonitis, myocarditis, pericarditis, nephritis, colitis Atypical lymphocytes, thrombocytopenia, neutropenia, anemia Leukocytosis with eosinophilia in 50-90%, and mononucleosis in 40% [3] [4] Differential Diagnosis Erythematous rash Positive Nikolskys sign Febrile Staphylococcal scalded skin syndrome (children) Toxic epidermal necrolysis/SJS (adults) Afebrile Toxic epidermal necrolysis Negative Nikolskys sign Febrile Toxic shock syndrome Kawasaki disease Scarlet fever DRESS syndrome Cellulitis Acute generalized exanthematous pustulosis Afebrile Alcohol intoxication Anaphylaxis Cellulitis Dermatitis (multiple types) Drug rash Erysipelas Erythema multiforme Exfoliative erythroderma Scombroid Vancomycin infusion reaction Evaluation Workup CBC with diff BMP LFTs Coags ESR CRP Viral hepatitis panel Biopsy Diagnosis Table of Severe Drug Rashes Management Discontinue suspected drug Supportive care: antipyretic, anti-pruritic Fluid management as in burn Systemic steroids and/or cyclosporin/immunosuppressants in severe cases (controversial) Hepatitis, pneumonitis, extensive exfoliative dermatitis Other severe systemic manifestations Family counseling as possible genetic component Disposition Admit See Also Erythematous rash External Links Medscape - Drug Erruptions The DRESS Syndrome: The Great Clinical Mimicker References Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome

If youre working with a reputable company with decades of experience and a highly trained team of cleaning experts, you shouldnt be paying more than $300 to have your dress professionally cleaned, regardless of whether you purchased your wedding dress off the rack or if it is a designer dress

To make this Greek dressing even tastier, use fresh oregano instead of dried