{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T22:29:12Z","timestamp":1750112952152,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Drug\u2010induced hypersensitivity syndrome (DiHS), or drug reaction with eosinophilia and systemic symptoms (DRESS), is a delayed and severe immune response to certain medications. We investigated vancomycin\u2010induced DiHS\/DRESS, notable for frequent and severe organ involvement, to describe its specific histopathology and the correlations between histopathologic and clinical findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was conducted to identify patients between 2006 and 2022 who received vancomycin, had archived skin biopsy specimens, and were scored as having probable or definite DiHS\/DRESS. Clinical features were retrospectively collected, and biopsy specimens were reviewed by a board\u2010certified dermatopathologist. A subset of histopathologic and clinical features was analyzed for statistical correlation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three patients met the inclusion criteria. Most biopsy specimens (87%) showed an eczematous reaction pattern; 17 (74%) showed a secondary reaction pattern. Spongiosis (87%) and neutrophilic infiltration (91%) were common epidermal characteristics. The dermal inflammatory infiltrate was frequently superficial (87%) and consistently included plasma cells (96%). Eosinophils were present in the dermis in 70% of cases. Parakeratosis negatively correlated with liver involvement and positively correlated with desquamative rash. Epidermal lymphocytes were negatively correlated with the RegiSCAR score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vancomycin\u2010associated DiHS\/DRESS histopathology was characterized by a frequent eczematous reaction pattern, multiple coexisting reaction patterns, and epidermal neutrophilic infiltration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.14804","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T08:56:14Z","timestamp":1742892974000},"page":"442-451","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Histopathologic Features in Vancomycin\u2010Associated Drug\u2010Induced Hypersensitivity Syndrome"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9699-5515","authenticated-orcid":false,"given":"Hannah B.","family":"Haberecht","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel L.","family":"Ziebart","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia C.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin","family":"Todd","sequence":"additional","affiliation":[{"name":"Mayo Clinic Division of Clinical Trials and Biostatistics  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark D.","family":"Davis","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Wetter","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio C.","family":"Sartori\u2010Valinotti","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafsa M.","family":"Cantwell","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian T.","family":"McEvoy","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nessa Aghazadeh","family":"Mohandesi","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology  Rochester Minnesota 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