Dress syndrome case in covid-19 patient: Drug-induced or disease-related?

Abstract

Drug rash with eoshinophilia and systemic symptoms (DRESS) syndrome is one of the rare drug reactions with a mortality rate of approximately 10%. Clinically the DRESS syndrome is char-acterized by diffuse maculopapular exanthema, various hematologi-cal abnormalities, liver and kidney dysfunction, fever, and lymphadenopathy. There are many drugs in the etiology of DRESS syndrome, and Phenytoin, Carbamazepine, phenobarbital, Allopuri-nol, Abacavir and Sulfonamides are among the most reported. Hy-droxychloroquine is used in the treatment of COVID-19 disease due to its antiviral effects shown in vitro. Some of the dermatological side effects of Hydroxychloroquine reported in the literature are alopecia, hyperpigmentation and itching of the skin, as well as Steven-Johnson syndrome/toxic epidermal necrolysis, acute generalized exantoma-tous pustulosis, DRESS syndrome, which are hypersensitivity reac-tions. Here, we wanted to present a patient who was diagnosed as DRESS syndrome due to his widespread skin rash and systemic signs that developed during the treatment of COVID-19 disease in order to draw attention to the drug reactions that may develop during the pandemic and skin involvement due to COVID-19. At the same time, we wanted to draw attention to the complexity of drug reaction or skin involvement in the course of COVID-19 disease.