drug rash with eosinophilia and systemic symptoms (dress) in phenytoin therapy: a case report

Drug rash with eosinophilia and systemic symptoms (dress) is a severe adverse drug reaction. several drugs represent potential etiologic factors for dress syndrome, with aromatic antiepileptics being the most common causative drug. one of the aromatic antiepileptics is phenytoin. a 32-year-old male came with complaints of red rashes on the whole body for 2 weeks. two weeks before hospitalization, the patient took phenytoin. with a score of 8, the regiscar scoring system classified this patient as a definitive case of dress. in our case, the pharmacotherapy given included methylprednisolone iv, diphenhydramine injection, and metronidazole infusion. oral medication such as leviracetam 250 mg, n-acetylcysteine. leviracetam is given with the consideration that this drug is a non-aromatic aed with less frequent dress. topical steroids are given to reduce cutaneous symptoms.