An Unusual Manner Is Up to Allopurinol: DRESS Syndrome

Introduction: Allergic reactions can be observed in many different ways in the emergency department. Case Report: Due to itchy skin eruptions, especially on her face and body, a 60-year-old female patient was admitted to the emergency department. It was learned from the history of the patient that the administration of allopurinol was started owing to high uric acid levels in routine examinations 15 days ago. Vital signs were stable in the physical examination. There were erosion and hemorrhagic crusts on the lips and maculopapular lesions that got pale after pressing with common erythema on the oral mucosa, face, body, and back. A dermatology consultation was asked for the patient, with a preliminary diagnosis of Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. Then, previous treatment of the hospitalized patient was stopped, and antihistaminic and systemic steroid treatments were applied. Consequently, the patient was discharged with full recovery. Conclusion: DRESS syndrome should be considered in patients who are admitted to the emergency department with a history of using allopurinol and have skin lesions and deterioration in liver function tests showing involvement of internal organs.