Drug rash with eosinophilia and systemic symptoms syndrome
ICD-10 D72.12 is a billable code used to indicate a diagnosis of drug rash with eosinophilia and systemic symptoms syndrome.
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by a triad of symptoms: fever, rash, and internal organ involvement, often accompanied by eosinophilia. The condition typically arises after exposure to certain medications, including anticonvulsants, antibiotics, and allopurinol. Clinically, patients may present with a widespread rash, lymphadenopathy, and hematological abnormalities such as leukopenia or eosinophilia. Systemic symptoms can include hepatitis, nephritis, pneumonitis, and myocarditis, leading to significant morbidity. The pathophysiology involves a complex immune response, where drug metabolites may act as haptens, triggering T-cell activation and cytokine release. Diagnosis is primarily clinical, supported by laboratory findings of eosinophilia and elevated liver enzymes. Prompt recognition and discontinuation of the offending drug are critical to management, along with supportive care and, in severe cases, corticosteroids.
Detailed description of the rash, including morphology and distribution.
Patients presenting with drug-induced rashes and systemic symptoms.
Need for correlation between drug exposure and onset of symptoms.
Comprehensive history of drug exposure and immune response.
Patients with a history of drug allergies presenting with eosinophilia.
Assessment of potential underlying immunodeficiencies.
Used to assess eosinophilia in suspected DRESS syndrome.
Document the indication for CBC and results showing eosinophilia.
Relevant for both dermatology and allergy/immunology specialties.
Common drugs include anticonvulsants (like phenytoin), sulfonamides, allopurinol, and certain antibiotics. It's essential to review the patient's medication history thoroughly.
