TABLE 3

Registry of Severe Cutaneous Adverse Reactions diagnostic criteria for drug reaction with eosinophilia and systemic symptoms

Criteria^a	Score^b
Criteria^a	No	Yes	Unknown
1) Acute skin eruption
a) More than 50% body surface area affected	0	+1	0
b) Rash characteristic of DRESS	-1	+1	0
c) Biopsy suggesting DRESS	-1	0	0

2) Fever > 38.5°C	-1	0	-1

3) Lymphadenopathy (> 1 site, > 1 cm)	0	+1	0

4) Internal organ involvement^c	0	+1	0

5) Eosinophilia

a) Eosinophils 700-1,499, or 10%-19.9% if leukocytes < 4.0 × 10⁹ L		+1

b) Eosinophils > 1,500 or > 20% if leukocytes < 4.0 × 10⁹ L		+2

6) Atypical lymphocytes	0	+1	0

7) Thrombocytopenia

Additional parameters
Resolution in > 15 days	-1	0	-1

Exclusion of: antinuclear antibodies, blood culture, serology for hepatitis A, B, and C, chlamydia, or mycoplasma		+1

↵a Diagnosis requires 3 or more criteria.
↵b Likelihood of diagnosis based on total score: < 2 = no; 2-3 = possible; score 4-5 = probable; score > 5 = definite.
↵c Maximum of 2 points.
DRESS = drug reaction with eosinophilia and systemic symptoms
Adapted from information in reference 21.