A 34-year-old woman develops widespread erythema, fever, and facial edema 4 weeks after starting carbamazepine. She has lymphadenopathy, transaminitis (ALT 280 U/L), and eosinophilia (1800/µL). Skin biopsy shows spongiosis, interface dermatitis, and eosinophilic infiltrate. Which scoring system best quantifies the likelihood of this diagnosis?

• A SCORTEN
• B ALDEN score
• C DRESS severity index
• D RegiSCAR score ✓

Explanation

The RegiSCAR score (scoring system for Drug Reaction with Eosinophilia and Systemic Symptoms) is the validated tool for DRESS diagnosis, scoring lymphadenopathy, blood count abnormalities (eosinophilia, atypical lymphocytes), organ involvement, and skin extent. A score ≥5 indicates definite DRESS. SCORTEN is for SJS/TEN mortality prediction. ALDEN (Algorithm of Drug Causality for Epidermal Necrolysis) attributes causality in SJS/TEN specifically, not DRESS.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.