Table 1 DRESS Diagnostic Scoring systems (“DRESS Syndrome Foundation: diagnosis and treatment,” [1], Bocquet, Bagot, and Roujeau, [8])

More than 3 of the criteria are required for the diagnosis of DRESS:

1. Hospitalization

2. Reaction suspected to be drug related

3. Acute rash

4. Fever above 38 °C

5. Enlarged lymph nodes involving at least two sites

6. Involvement of at least one internal organ

7. Blood count abnormalities:

Lymphocytes above or below laboratory limits, Eosinophils above laboratory limits (in percentage or absolute count), Platelets below laboratory limits

Typical DRESS (presence of all 7 criteria); atypical DIHS (all criteria present except lymphadenopathy and HHV-6 reactivation):

1. HHV-6 reactivation

2. Prolonged clinical symptoms 2 weeks after discontinuation of causative drug

3. Maculopapular rash developing > 3 weeks after starting drug

4. Fever above 38 °C

5. Lymphadenopathy

6. ALT > 100 U/L or other organ involvement

7. Leukocyte abnormalities (at least one): Leukocytosis (> 11 × 10⁹/L), Atypical lymphocytosis (> 5%), Eosinophilia (1.5 × 10⁹/L)

DRESS is confirmed by presence of 3 criteria:

1. Cutaneous drug eruption

2. Adenopathies > 2 cm in diameter or hepatitis (liver transaminases > 2 times upper limit of normal) (or) interstitial nephritis (or) interstitial pneumonitis (or) carditis

3. Hematologic abnormalities eosinophilia > 1.5 × 10⁹/L (or) atypical lymphocytes