Publications by authors named "Benoit Ben Said"

13 Publications

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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Series of 49 French Pediatric Cases.

J Allergy Clin Immunol Pract 2021 Jul 29. Epub 2021 Jul 29.

Service de Dermatologie, Hôtel Dieu, Centre Hospitalier Universitaire de Nantes, Nantes, France. Electronic address:

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal adverse reaction. It can be difficult to diagnose, even more so among children, because symptoms may mimic other commonly encountered pediatric conditions.

Objective: To describe clinical and laboratory features of DRESS syndrome in the pediatric population (age ≤18 years) and establish causative agents and treatment modalities.

Methods: This was a multicenter retrospective study of probable and definite DRESS cases (Registry of Sever Cutaneous Adverse Reaction score ≥ 4) in children hospitalized in 15 French university hospitals between 2000 and 2020.

Results: We included 49 cases. All children had fever and rash, 69.4% had lymphadenopathy, and 65.3% had facial edema. The most common organ affected was the liver (83.7%). Treatment consisted of topical corticosteroid in only 30.6% and systemic corticosteroid in 55.1%; 12.2% received intravenous immunoglobulin. Among probable and likely culprit drugs, 65% were antibiotics and 27.5% were antiepileptics, median time to DRESS symptom onset after initiation of 15 days (13 days with antibiotics and 21 days with antiepileptics). Twenty-seven children had allergy assessment for causative agents, 65.4% of whom had positive tests.

Conclusions: Culprit drugs are frequently antibiotics and antiepileptic drugs, and onset is often less than 2 weeks after treatment starts, especially with antibiotics. Treatment with topical corticosteroids appears to be sufficient in the least severe cases. Treatment by systemic corticosteroid therapy remains the reference treatment in case of severe organ damage.
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http://dx.doi.org/10.1016/j.jaip.2021.07.025DOI Listing
July 2021

Dupilumab for severe generalized eczematous eruption complicating common variable immunodeficiency.

Eur J Dermatol 2021 Feb;31(1):93-94

Severe Cutaneous Drug Reaction Reference Centre Dermatology, CHU Lyon, Department of Dermatology, Lyon, France.

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http://dx.doi.org/10.1684/ejd.2020.3954DOI Listing
February 2021

Generalized bullous fixed drug eruption: Trazodone as a new culprit.

Contact Dermatitis 2020 Mar 4;82(3):192-193. Epub 2019 Dec 4.

Department of Immuno-allergology, CHU Brugmann, Brussels, Belgium.

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http://dx.doi.org/10.1111/cod.13436DOI Listing
March 2020

Antituberculosis Drug-Associated DRESS: A Case Series.

J Allergy Clin Immunol Pract 2018 Jul - Aug;6(4):1373-1380. Epub 2017 Dec 20.

Severe Cutaneous Adverse Drug Reaction National Reference Center, Dermatology, Hôpital Edouard Herriot, Lyon, France.

Background: Although antituberculosis drug-associated drug reaction with eosinophilia and systemic symptoms (DRESS) is rarely reported, its diagnosis should not be dismissed. Its management implies an early withdrawal of suspected drugs.

Objective: The objective of this study was to describe the characteristics of antituberculosis drug-associated DRESS and to identify the most likely involved drugs.

Methods: We searched for potential cases of DRESS with rifampicin, isoniazid, pyrazinamide, and ethambutol reported from January 1, 2005, to July 30, 2015, in the French pharmacovigilance database. A literature review was also performed.

Results: Sixty-seven cases of antituberculosis drug-associated DRESS were analyzed (40 women and 27 men, median age of 61 years). Liver and kidneys were the most frequently involved organs. Two patients died from DRESS. Skin tests were performed in 11 patients and were positive in 8 cases. Discrepancies between epicutaneous tests and reintroduction of the culprit drugs were observed for 2 patients with a premature reintroduction of antituberculosis drugs in 1 case. Antituberculosis drugs were the only suspects in 20 cases. As for the literature data, rifampicin was the most suspected drug because of its larger indications, but in case of tuberculosis infections, isoniazid was the most suspected drug.

Conclusions: We described the largest case series of first-line antituberculosis drug-associated DRESS in the literature. All antituberculosis drugs pose a risk of DRESS. An early withdrawal of the culprit drugs is essential. A drug allergy evaluation must be performed to optimize the second-line treatment of tuberculosis infection.
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http://dx.doi.org/10.1016/j.jaip.2017.11.021DOI Listing
November 2019

Fatal DRESS syndrome under tocilizumab treatment for seronegative polyarthritis.

J Allergy Clin Immunol Pract 2018 May - Jun;6(3):1048-1049. Epub 2017 Nov 7.

Internal Medicine Department, CHU CROIX ROUSSE, Lyon, France.

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http://dx.doi.org/10.1016/j.jaip.2017.08.041DOI Listing
October 2019

DRESS Syndrome in the ICU: When a Patient Is Treated with Multiple Drugs.

Case Rep Crit Care 2016 24;2016:9453286. Epub 2016 Jan 24.

Département d'Anesthésie-Réanimation, Hôpital Edouard Herriot, 5 place d'Arsonval, 69003 Lyon, France; Université Claude Bernard Lyon 1, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France.

The Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is life-threatening. It associates a skin condition with hematological and visceral disorders. The DRESS syndrome diagnosis in the intensive care unit (ICU) is difficult as clinical features are nonspecific. Furthermore, the need to treat patients with multiple drugs usually prevents the identification of the causative drug. We report the case of a patient who developed two bouts of DRESS caused by piperacillin-tazobactam, the first being complicated with a distributive shock. Cases of DRESS occurring inside ICU are seldom reported. However, any intensivist may encounter this situation during his career and should be aware of its diagnostic and management specific aspects.
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http://dx.doi.org/10.1155/2016/9453286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745628PMC
February 2016

Allergic delayed drug hypersensitivity is more frequently diagnosed in drug reaction, eosinophilia and systemic symptoms (DRESS) syndrome than in exanthema induced by beta-lactam antibiotics.

J Dermatol Sci 2015 Oct 28;80(1):71-4. Epub 2015 Aug 28.

Allergy and Clinical Immunology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, France; Université de Lyon, France; CIRI - INSERM U1111 - CNRS UMR5308, Université Lyon 1, ENS, 21 Avenue Tony Garnier, 69365 Lyon Cedex 07, France. Electronic address:

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http://dx.doi.org/10.1016/j.jdermsci.2015.07.014DOI Listing
October 2015

Role of T cells in nonimmediate allergic drug reactions.

Curr Opin Allergy Clin Immunol 2009 Aug;9(4):305-10

Université Lyon1, UFR Lyon Sud, Oullins 69600, France.

Purpose Of Review: This review presents the current knowledge of the role of T cells in drug allergy manifesting as exanthematous, pustular and bullous skin diseases, collectively referred to as nonimmediate allergic drug reactions.

Recent Findings: Both CD4+ and CD8+ T cells producing type 1 and type 2 cytokines and endowed with cytotoxic properties are involved in nonimmediate allergic drug reactions. Recent studies have confirmed that CD8+ T cells play a major role in the pathophysiology of nonimmediate allergic drug reactions, and have characterized new cytotoxic molecular pathways responsible for the severity of the bullous forms of nonimmediate allergic drug reactions.

Summary: Nonimmediate allergic drug reactions are mediated by T cells and mostly affect the skin. Nonimmediate allergic drug reactions comprise several diseases ranging from the frequent and benign maculo-papular exanthema to the severe and rare toxic epidermal necrolysis. Progress in the knowledge of the pathophysiology of nonimmediate allergic drug reactions comes from a better understanding of the mechanisms of drug recognition by T cells and from a careful analysis of the phenotype and functions of CD4+ and CD8+ T cells infiltrating the skin lesions. Recent studies have confirmed that the different clinical forms of nonimmediate allergic drug reactions are associated with distinct types of T cell-mediated skin inflammation. However, CD8+ T cells appear as major effector T cells in most of the nonimmediate allergic drug reactions. Future studies to analyze the early cellular and molecular events leading to the development of the allergic skin reaction will be helpful in order to define diagnostic and therapeutic targets.
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http://dx.doi.org/10.1097/ACI.0b013e32832d565cDOI Listing
August 2009

Granular parakeratosis in a patient treated with liposomal doxorubicin for ovarian carcinoma.

J Am Acad Dermatol 2008 May;58(5 Suppl 1):S84-7

Department of Dermatology, Edouard Herriot Hospital, Lyon, France.

Granular parakeratosis is a rare benign dermatosis caused by an acquired disorder of keratinization that usually manifests with reddish-brown keratotic papules and plaques in intertriginous areas. It has specific histologic features but its pathogenesis remains unclear. Its frequency is probably underestimated because the condition is usually misdiagnosed as simple intertrigo. We report herein a new case of granular parakeratosis in a woman treated with liposomal doxorubicin for ovarian carcinoma that showed complete remission after discontinuation of chemotherapy. The relationship between granular parakeratosis and chemotherapy is discussed.
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http://dx.doi.org/10.1016/j.jaad.2007.05.031DOI Listing
May 2008
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