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  • Title: [Skin reaction to carbamazepine or DRESS syndrome: a case presentation].
    Author: Cabrera Fundora EJ, Cabrera Osorio Y, Cabrera Osorio C.
    Journal: Medwave; 2016 Feb 25; 16(1):e6389. PubMed ID: 26938717.
    Abstract:
    Carbamazepine is a frequently used drug that can produce adverse reactions like vertigo, somnolence and severe skin reactions like Drug Rash with Eosinophilia and Systemic Symptoms Syndrome (DRESS Syndrome). This syndrome is characterized by a late-appearing, slow-progressing cutaneous eruption accompanied by atypical lymphocytes, eosinophilia, and systemic symptoms such as fever, lymphadenopathy, hepatic compromise, and renal dysfunction that can be severe enough to cause death. We present a case that aims to highlight the importance of an early diagnosis of DRESS syndrome to adjust therapy and improve survival. The patient is a female patient prescribed carbamazepine for trigeminal neuralgia who presented with skin lesions, which were initially attributed to a hypersensitivity reaction. The lesions worsened in spite of treatment and systemic symptoms ensued. A diagnosis of DRESS syndrome was proposed and steroid treatment was initiated with rapid improvement. La carbamazepina es un medicamento de empleo habitual que puede producir efectos secundarios y en algunos casos reacciones adversas como vértigos, somnolencia y reacciones cutáneas que pueden ser severas como el síndrome DRESS (Drug Rash with Eosinophilia and Systemic Symptoms). Se caracteriza por erupción cutánea tardía y lenta progresión, linfocitos atípicos con eosinofilia y síntomas sistémicos como fiebre, adenopatías, hepatopatía y trastornos renales, pudiendo llegar a la muerte del paciente. Se presenta un caso para destacar la importancia del diagnóstico temprano del síndrome DRESS, que garantice un manejo adecuado para la supervivencia del paciente. Es una paciente bajo tratamiento con carbamazepina para neuralgia del trigémino, que al tiempo comienza con lesiones cutáneas que se interpretan como reacción de hipersensibilidad. Al no mejorar con tratamiento inicial y empeorar el cuadro cutáneo, acompañándose de síntomas generales, se realizan análisis complementarios y se plantea el diagnóstico de síndrome DRESS que se resuelve definitivamente con esteroides.
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