Systemic drug reactions with skin involvement: Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS

Skin is often affected in adverse drug reactions. Although the majority of cutaneous adverse drug reactions are benign and self-limiting, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug rash with eosinophilia and systemic symptoms (DRESS), affecting multiple organs and systems, are potentially fatal. Many organs can be affected, including the mucosal membranes, gastrointestinal tract, liver, lungs, kidneys, and eyes. We discuss the causes, pathophysiologic aspects, and main clinical features of SJS, TEN, and DRESS as systemic diseases with skin involvement.