DRESS syndrome is a potentially life-threatening drug-induced hypersensitivity reaction that causes fever, lymphadenopathy, hematological abnormalities, and multi-organ involvement, including the skin. Despite its low incidence, it can appear in children, being antiepileptics the most frequently associated drugs.

A 7-year-old boy was diagnosed in June 2018 with symptomatic focal epilepsy and therefor he started treatment with oxcarbazepine. Ten days later, the patient presented a confluent urticariform rash with palmoplantar involvement, laterocervical lymphadenopathy, fever, and poor general condition; he was Initially  diagnosed with viriasis. However, after being assessed by the Allergology department it was decided to suspend oxcarbazepine and started treatment with corticosteroids.

Due to the severity of the condition, the patient is admitted with multidisciplinary management (Dermatology, Pediatrics and Allergology) and analytical follow-up. Serological studies and skin biopsy are also performed.

After withdrawal of oxcarbazepine, treatment was started with corticosteroids at 2mg/kg/day in a descending regimen and antihistamines, with regression of skin lesions and normalization of analytical parameters. Corticosteroid treatment was maintained for 4 months with a well-controlled relapse at 2 months. Laboratory tests revealed a maximum eosinophilia of 1500 10e3/μL, elevated CRP (2.3 mg/dL) and abnormal liver function tests (GPT 80 U/L). Serologies including human herpes virus 6 and 7 were negative. In the Pathological Anatomy study, it was observed superficial and interstitial perivascular dermatitis of lymphocyte predominance as well as the presence of occasional neutrophils and eosinophils in vessels.

DRESS syndrome is an uncommon disease in pediatric population which requires a high degree of clinical suspicion in cases of rash after starting taking a new drug. It is important to highlight the importance of an early diagnosis to withdraw the suspected drug and thus avoid possible complications.