Drug Reaction with eosinophilia and systemic symptoms with alopecia universalis and vitiligo

Drug reactions with eosinophilia and systemic symptoms (DRESS) are rare and potentially fatal adverse hypersensitivity reaction to some drugs, especially anticonvulsants. The syndrome affects not only the skin but also other organs, especially the liver. The incidence can vary from 1 to 5 cases per 10.000 patients exposed to anticonvulsants. The recognition of the syndrome is of fundamental importance since the mortality rate is between 10 and 40%. Once the diagnosis is established, the triggering drug must be identified and discontinued. Corticosteroids are usually associated with therapy. Autoimmune sequelae have been reported, including vitiligo and rarely alopecia. Alopecia universalis is a variant of alopecia areata, characterized by hair loss throughout the body. We report a case of DRESS, associated with two autoimmune dermatological diseases: alopecia universalis and vitiligo