Sulfasalazine-Induced DRESS Syndrome: A Case Report

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially fatal drug hypersensitivity reaction. We report a 13-year-old male with enthesitis-related arthritis who developed DRESS three weeks after initiating sulfasalazine therapy. He presented with diffuse erythematous rash, facial edema, oral ulcerations, and marked eosinophilia. The diagnosis was established using RegiSCAR criteria after excluding alternative causes. Prompt discontinuation of sulfasalazine and initiation of corticosteroids led to rapid clinical improvement. This case highlights the importance of early recognition and management of sulfasalazine-induced DRESS in pediatric patients.