Ganciclovir‐induced drug reaction with eosinophilia and systemic symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse involving multiorgan failure, complex interaction of various drugs, human herpesvirus reactivation immune abnormalities suggested as the aetiology. We herein present case 70-year-old man one-week history fever, facial oedema, erythematous macules purpura on his trunk extremities. He had anti-TIF1γ antibody-positive dermatomyositis was treated prednisolone sodium succinate (20 mg/day). Three weeks earlier, he ganciclovir (250 mg/day) for 7 days to treat asymptomatic cytomegalovirus viraemia. Laboratory investigations revealed atypical lymphocytes elevated liver enzyme levels. A histological examination showed interface dermatitis necrotic keratinocytes, perivascular infiltration eosinophils in upper dermis erythrocyte extravasation without vasculitis. lymphocyte transformation test (LTT) positive (stimulation index: 260%; normal: <180%). diagnosed DRESS caused by basis clinical findings course (Definite; RegiSCAR score: 7). (40 topical clobetasol propionate (0.05%) ointment twice daily. After initiation treatment, skin lesions laboratory gradually improved. To our knowledge, this first ganciclovir. The patients whom used are often immunosuppressed may be overlooked causative drug conventional tests. considered that LTT useful identifying drugs DRESS, especially patients, such case.