Accepted for/Published in: JMIR Dermatology
Date Submitted: Jul 24, 2022
Date Accepted: Jun 13, 2023
Date Submitted to PubMed: Aug 26, 2023
Cyclosporine in the Treatment of Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome: A Case Series
ABSTRACT
Background:
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, life-threatening reaction to a culprit drug that frequently involves end-organ damage. Corticosteroids are the first-line treatment for DRESS; however, corticosteroids may be contraindicated in certain patient populations. There are currently only 54 cases of cyclosporine for the treatment of DRESS reported in the literature.
Objective:
The aim of this case series was to examine the treatment of DRESS with cyclosporine in a large patient cohort by aggregating time to symptom resolution, recurrence rate, and treatment dose and duration.
Methods:
This study was a retrospective cohort study. Patients diagnosed with DRESS by a board-certified dermatologist and treated at the University of Colorado Hospital from 2015-2019 were included.
Results:
19 occurrences of DRESS met our inclusion criteria. 17 of 19 patients in our cohort (89%) had resolution of symptoms with a short course of cyclosporine (mean treatment length of 5.26 days). DRESS relapse after treatment with cyclosporine occurred in 3 of 19 occurrences (16%) of the cohort.
Conclusions:
Our study supports the use of cyclosporine in the treatment of DRESS, particularly in patients who are unable to sustain prolonged immunosuppression. Further research is necessary to compare the efficacy of cyclosporine to the current standard of care in a larger study population and investigate long-term outcomes.
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