{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:58:42Z","timestamp":1759334322601,"version":"build-2065373602"},"reference-count":5,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"3","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>\u00a0\nIntroducci\u00f3n: Las reacciones adversas cut\u00e1neas graves a los medicamentos (SCAR) superpuestas se definen como casos que cumplen criterios para el diagn\u00f3stico definitivo o probable de al menos 2 reacciones asociadas a medicamentos, seg\u00fan los sistemas de puntuaci\u00f3n. Presentamos el caso de una superposici\u00f3n de SCAR.\nReporte de Caso: Femenino de 53 a\u00f1os, con diagn\u00f3stico de diabetes en tratamiento con metformina y linagliptina e hipertensi\u00f3n arterial en tratamiento con nifedipino. Secundario a crisis convulsiva aislada inici\u00f3 manejo con fenito\u00edna y 5 semanas despu\u00e9s present\u00f3 eritema en regi\u00f3n tor\u00e1cica acompa\u00f1ada de prurito la cual se extiende a abdomen, iniciando manejo con antihistam\u00ednico, con pobre mejor\u00eda progresando a eritema generalizado y fiebre. A su ingreso presento lesiones cut\u00e1neas polim\u00f3rficas generalizadas de tipo exantema maculopapular y lesiones ampollosas en antebrazos, as\u00ed como lesiones localizadas en cara de tipo p\u00fastulas. Laboratorios: Leucocitosis, con neutrofilia (67%), eosinofilia = 3,880\/mm3 y lesi\u00f3n renal aguda. Biopsia: Dermatitis cr\u00f3nica de interfase, perivasculitis superficial y eosinofilia. Acorde a sistemas de puntuaci\u00f3n RegiSCAR = 4 puntos y EuroSCAR = 6 puntos, ambos resultados como probable. Inici\u00f3 manejo esteroide con metilprednisolona a 1.5 mg\/kg por 3 d\u00edas y posteriormente prednisona en dosis reducci\u00f3n.\nConclusi\u00f3n: La paciente presenta una reacci\u00f3n adversa cut\u00e1nea grave, 5 semanas posterior al inicio de manejo con fenito\u00edna, presentando acorde a escalas una superposici\u00f3n. Secundario a las ambig\u00fcedades entre las SCAR, los casos confirmados de superposici\u00f3n son poco frecuentes. En la etapa aguda de la enfermedad, la identificaci\u00f3n temprana de las SCAR puede ser dif\u00edcil debido a caracter\u00edsticas superpuestas.\nPalabras clave: DRESS; Pustulosis exantem\u00e1tica aguda; F\u00e1rmacos; Reacci\u00f3n de hipersensibilidad; Fenito\u00edna.<\/jats:p>","DOI":"10.29262\/ram.v72i3.1538","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:29:38Z","timestamp":1759242578000},"page":"241","source":"Crossref","is-referenced-by-count":0,"title":["&lt;b&gt;Hipersensibilidad medicamentosa: cuando s\u00edntomas sist\u00e9micos y p\u00fastulas convergen &lt;\/b&gt;","&lt;b&gt;\u00a0 Drug hypersensitivity: When systemic symptoms and pustules converge\u00a0&lt;\/b&gt;"],"prefix":"10.29262","volume":"72","author":[{"given":"Ariadna","family":"Palafox Olvera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgardo Adrian","family":"Puerto D\u00edaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Mellado \u00c1brego","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia","family":"Hern\u00e1ndez Nieto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Castillo Narva\u00e9z","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol Vivian","family":"Moncayo Coello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11808","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"63299","doi-asserted-by":"crossref","unstructured":"1. Bouvresse S, Valeyrie-Allanore L, Ortonne N, et al. Toxic epidermal necrolysis, DRESS, AGEP: do overlap cases exist?. Orphanet J Rare Dis. 2012;7:72. Published 2012 Sep 25. doi:10.1186\/1750-1172-7-72","DOI":"10.1186\/1750-1172-7-72"},{"key":"63300","doi-asserted-by":"crossref","unstructured":"2. Pinto Gouveia M, Gameiro A, Coutinho I, Pereira N, Cardoso JC, Gon\u00e7alo M. Overlap between maculopapular exanthema and drug reaction with eosinophilia and systemic symptoms among cutaneous adverse drug reactions in a dermatology ward. Br J Dermatol. 2016;175(6):1274-1283. doi:10.1111\/bjd.14704","DOI":"10.1111\/bjd.14704"},{"key":"63301","doi-asserted-by":"crossref","unstructured":"3. Yaswanta K. Gummadi,Ashley E. Sutherland,Kristin M. Ikeda,Lori Connors,Luke Y. C. Chen, Lamotrigine and anti\u2010seizure medications in HLH : A systematic review , British Journal of Haematology, (2025).","DOI":"10.1111\/bjh.20221"},{"key":"63302","doi-asserted-by":"crossref","unstructured":"4. Criado PR, Ianhez M, Miot HA, Criado RFJ, Talhari C, M\u00fcller Ramos P. DRESS syndrome: an interaction between drugs, latent viruses, and the immune system. An Bras Dermatol. 2025;100(1):104-120. doi:10.1016\/j.abd.2023.12.010","DOI":"10.1016\/j.abd.2023.12.010"},{"key":"63303","doi-asserted-by":"crossref","unstructured":"5. Singh GK, Mitra B, Arora S, et al. A retrospective, 5-year, clinicoepidemiological study of severe cutaneous adverse reactions (SCARs). Int J Dermatol. 2021;60(5):579-588. doi:10.1111\/ijd.15416","DOI":"10.1111\/ijd.15416"}],"container-title":["Revista Alergia M\u00e9xico"],"original-title":[],"link":[{"URL":"https:\/\/revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1538\/2776","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1538\/2776","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:29:40Z","timestamp":1759242580000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaalergia.mx\/ojs\/index.php\/ram\/article\/view\/1538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":5,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,30]]}},"URL":"https:\/\/doi.org\/10.29262\/ram.v72i3.1538","relation":{},"ISSN":["2448-9190","0002-5151"],"issn-type":[{"type":"electronic","value":"2448-9190"},{"type":"print","value":"0002-5151"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}