Skeletal myositis as the sole feature of relapsing drug reaction with eosinophilia and systemic symptoms syndrome

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome represents a potentially life-threatening systemic immune response to medication. It is characterized by rash, fever, lymphadenopathy, eosinophilia, and internal organ involvement, most commonly hepatitis. We report a case of DRESS syndrome caused by sulfasalazine with acute morbilliform rash, fever, eosinophilia, and hepatitis with subsequent skeletal muscle involvement. To date, literature reports of skeletal muscle involvement with DRESS syndrome have been limited to 2 cases, only one of which involved histopathologic evidence of eosinophilic infiltration on skeletal muscle biopsy.

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