DRESS syndrome diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Serge Korjian M.D.


There is no gold standard for the diagnosis of DRESS syndrome. Two diagnostic criteria have been proposed: The RegiSCAR criteria and the Japanese Consensus Group criteria.

Diagnostic Criteria

  • There is no gold standard for the diagnosis of DRESS syndrome.
  • Two diagnostic criteria have been proposed:
  • The RegiSCAR criteria[1]
  • The Japanese Consensus Group criteria[2]

The following table illustrates the diagnostic criteria for the diagnosis of DRESS syndrome based on the RegiSCAR criteria and the Japanese consensus group criteria:

RegiSCAR inclusion criteria for DRESS syndrome
At least three of the four starred criteria are required for diagnosis
Japanese Consensus Group diagnostic criteria for DRESS/DIHS syndrome
A total of Seven criteria needed for the diagnosis of typical DRESS/DIHS syndrome / the first five criteria are required for the diagnosis of atypical DRESS/DIHS syndrome
Acute Rash* Maculopapular rash > 3 weeks following administration of drug
Fever > 38 °C* Prolonged clinical symptoms 2 weeks following the discontinuation of the suspected drug
Lymphadenopathy in at least two sites* Fever > 38 °C
Involvement of at least one internal organ* Liver function test abnormalities (ALT > 100 U/L) or other organ involvement
Hospitalization Leukocyte abnormalities
Reaction suspected to be drug-related Leukocytosis ( > 11 x 109/L)
Blood count abnormalities (lymphopenia or lymphocytosis, eosinophilia, thrombocytopenia) Atypical lymphocytosis (>5%)
Human herpesvirus 6 reactivation


  1. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. (2007). "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?". Response Br J Dermatol. 156 (3): 609–610. doi:10.1111/j.1365-2133.2006.07704.x. PMID 17300272.
  2. Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. (2007). "The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations". Response Br J Dermatol. 156 (5): 1045–92. doi:10.1111/j.1365-2133.2007.07807.x. PMID 17381452.

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