ABSTRACT
Las toxicodermias son dermatosis inducidas por medicamentos. Representan las principales reacciones adversas a medicamentos. El síndrome de hipersensibilidad severa a anticonvulsivantes o síndrome de DRESS ('Drug Rash with Eosinophilia and Systemic Symptoms') es una toxicodermia de baja incidencia, idiosincrática y potencialmente fatal. Los anticonvulsivantes son la causa más frecuente. En esta comunicación se describen las manifestaciones clínicas, paraclínicas y dificultades diagnósticas de tres casos clínicos. Su diagnóstico oportuno requiere alto grado de sospecha, conocer sus manifestaciones y los posibles diagnósticos diferenciales. La mortalidad está fundamentalmente vinculada a la presencia de falla hepatocítica aguda. La suspensión del medicamento implicado es el tratamiento fundamental. Se destaca la importancia de evaluar la relacion beneficio-riesgo a la hora de prescrbir un medicamento e incorporar la farmacovigilancia a la práctica clínica.
Toxicodermas are drug-induced dermatoses. They represent the most frequent adverse reactions to drug products. The Anticonvulsant severe hypersensitivity syndrome, or DRESS syndrome ('Drug Rash with Eosinophilia and Systemic Symptoms') is a rare, idiosyncratic, and potentially fatal toxicoderma. Anticonvulsants are its most frequent cause. In this communication, the clinical and paraclinical manifestations, as well as the diagnostic difficulties of three clinical cases are described. Its timely diagnosis requires a high degree of suspicion, the knowledge of its manifestations, and the possible differential diagnoses. Mortality is directly related with the presence of acute hepatocytic failure. Discontinuation of the drug product involved is fundamental. The importance of evaluating the benefit-risk ratio when prescribing a drug product, and of incorporating pharmacovigilance into clinical practice is highlighted.