{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T23:07:23Z","timestamp":1768518443581,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"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":["Pediatric Dermatology"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/objectives<\/jats:title><jats:p>Drug reaction with eosinophilia and systemic symptoms (<jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content>) is rare but potentially fatal in children. Fever and rash, which are salient features of <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content>, may mimic other commonly encountered pediatric conditions. We profiled the <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> cases in a tertiary children's hospital in Singapore.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of all pediatric <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> patients diagnosed from 2006 to 2016. Data on epidemiology, inciting drugs, clinical, pathologic manifestations, and treatment were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten patients aged 4\u201016\u00a0years old were diagnosed with <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> within the 10\u2010year period. Drugs implicated were antibiotics, such as trimethoprim\u2010sulfamethoxazole, and anticonvulsants, such as carbamazepine, phenobarbitone, and levetiracetam. All patients had fever and pruritic exanthems. Desquamation, purpura, and oral mucositis were also observed. Lymphadenopathy, hepatomegaly, and facial edema occurred frequently. There was liver involvement in all cases, but none progressed to liver failure. Seven patients had eosinophilia, and nine had atypical lymphocytosis. Other laboratory abnormalities included low hemoglobin, thrombocytosis, and prolonged coagulation times. All patients received systemic corticosteroids of varying durations and dosages. Systemic steroids were weaned after 19\u00a0days to 4\u00a0months. Disease resolution, with liver enzyme levels returning to normal, occurred within 28\u201090\u00a0days. One patient developed <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>\u2010receptor\u2010antibody\u2010positive hyperthyroidism 6\u00a0months after the onset of <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content>, while another patient developed chronic urticaria 4\u00a0months after resolution of <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early recognition of <jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> is important to ensure that the inciting drug is discontinued, and supportive treatment started expediently. Liver involvement was very common but responded well to systemic steroids.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.13812","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T13:13:15Z","timestamp":1553778795000},"page":"324-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Drug reaction with eosinophilia and systemic symptoms in a cohort of Asian children"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7778-4558","authenticated-orcid":false,"given":"Xiuhui D.","family":"Han","sequence":"first","affiliation":[{"name":"Dermatology Service KK Women's and Children's Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.\u2010A.","family":"Koh","sequence":"additional","affiliation":[{"name":"Dermatology Service KK Women's and Children's Hospital  Singapore 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