{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T00:21:49Z","timestamp":1793924509623,"version":"4.8.0"},"reference-count":212,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Drug reaction with eosinophilia and systemic symptoms or drug-induced hypersensitivity syndrome (DRESS\/DIHS) is one type of severe cutaneous adverse reaction (SCAR). It is featured by fever, widespread skin lesions, protracted clinical course, internal organ involvement, and possibly long-term autoimmune sequelae. The presence of high-risk human leukocyte antigen (HLA) alleles, hypersensitivity reaction after culprit drug ingestion, and human herpesvirus reactivation may all contribute to its complex clinical manifestations. Some recent studies focusing on the roles of involved cytokines\/chemokines and T cells co-signaling pathways in DRESS\/DIHS were conducted. In addition, some predictors of disease severity and prognosis were also reported. In this review, we provided an update on the current understanding of the pathogenesis, potential biomarkers, and the relevant therapeutic rationales of DRESS\/DIHS.<\/jats:p>","DOI":"10.3389\/fmed.2023.1187937","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T01:56:25Z","timestamp":1688003785000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Advances in understanding of the pathogenesis and therapeutic implications of drug reaction with eosinophilia and systemic symptoms: an updated review"],"prefix":"10.3389","volume":"10","author":[{"given":"Chun-Bing","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Kai","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuang-Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuen-Iu","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hung","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/978-3-642-00663-0_2","article-title":"Drug hypersensitivity reactions involving skin","volume":"196","author":"Hausmann","year":"2010","journal-title":"Handb Exp Pharmacol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1111\/all.13765","article-title":"Immune pathomechanism and classification of drug hypersensitivity","volume":"74","author":"Pichler","year":"2019","journal-title":"Allergy"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/j.jaip.2022.02.004","article-title":"Drug-induced hypersensitivity syndrome (DIHS)\/drug reaction with eosinophilia and systemic symptoms (DRESS): clinical features and pathogenesis","volume":"10","author":"Hama","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1056\/NEJMicm2116076","article-title":"Drug reaction with eosinophilia and systemic symptoms","volume":"387","author":"Hung","year":"2022","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1212\/WNL.29.11.1480","article-title":"Phenytoin hypersensitivity: 38 cases","volume":"29","author":"Haruda","year":"1979","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1001\/archderm.1981.01650010044023","article-title":"Dapsone hypersensitivity. 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