RegiSCAR Score for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

Many conditions can mimic DRESS. A thorough history, physical examination, and clinical evaluation are necessary to rule out alternative diagnoses.

If DRESS is suspected or confirmed:

• Discontinue all potential causative medications immediately.
• Avoid introducing new medications.
• Initiate supportive care (e.g., fluids, emollients), as appropriate.
• Monitor laboratory studies.
• Use the extent of organ involvement to guide severity grading (e.g., Delphi method has been proposed), which determines the aggressiveness of management, including:
  • Outpatient versus inpatient treatment (including medical ward versus ICU).
  • Topical or systemic corticosteroids.
  • Advanced organ support and closer monitoring.
  • Specialist consultations.

If DRESS is excluded:

• Evaluate for alternative diagnoses.
• Monitor for new or progressive signs and symptoms.
• Repeat the score if new data is available and DRESS remains on the differential.

If known, record the suspected offending drug in the patient's medical record to avoid future exposure.