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Figure 1

Target shield symptom.
Target shield symptom.

Figure 2

Massive maculopapular lesions covering the skin of the entire body.
Massive maculopapular lesions covering the skin of the entire body.

The RegiSCAR-Group Diagnosis Score for drug rash with eosinophilia and systemic symptoms (DRESS) (12)

Symptom No Yes Unknown
Fever (≥ 38.5°C) −1 0 −1
Enlarged lymph nodes (>=sites, >=1 cm) 0 1 0
Atypical lymphocytes 0 1 0
Eosinophilia, cells/μL 0 0
    700–1,499 or 10%–19.9% 1
    ≥ 1,500 or ≥20% 2
Skin rash 0 0
    Extent: >50% 0 1 0
    At least two of these: oedema, infiltration, purpura, scaling −1 1 0
    Biopsy suggesting DRESS −1 0 0
Internal organ involved 0 0
    One 1
    Two or more 2
Resolution in >=15 days −1 0 −1
At least three biological investigations performed and negative to exclude alternative diagnosis 0 1 0

The results of laboratory tests during hospitalisation

Results of the tests
Laboratory test Laboratory norm Day of hospitalisation
1 3 5 7 16
CRP (mg/L) <5.0 67.5 126.45 47.44 0.83
Procalcitonin (ng/mL) <0.5 0.81 8.09 0.4
Eosinophilia (%) 2–4 21 30 36 0.56
Haemoglobin (g/dL) 12.0–15.0 11.1 10.1 8.6 9.7
APTT (sec) 27–40 47.2 53.5 32.5
D-Dimers (ng/mL) <500 1510 2578 900
Albumin (g/dL) 3.8–5.4 4.3 3.0 4.5
Protein in the urine (mg/dL) Not present 10 50 Not present
Creatinine (mg/dL) 0.3–0.7 1.13 1.08 0.54
ALT (U/L) <44 12 12 12
AST (U/L) <48 18 12 14
TSH (mIU/mL) 0.3500– 4.9400 5.9817
fT4 (ng/dL) 0.70–1.48 1.26
fT3 (pg/mL) 1.71–3.71 2.18