HHV-6 reactivation was only observed in DRESS patients, not in any other cADR. In DRESS patients, some proinflammatory cytokines were significantly lower before or during HHV-6 reactivation.

The co-existence of three histopathological patterns in a skin specimen is characteristic in DRESS and shows a significant association with clinical severity.

Background Treatment guidelines for chronic spontaneous/idiopathic urticaria (CSU) are available; however, only 50% of patients are well controlled with approved doses of H1‐antihistamines, and certain patients remain symptomatic despite receiving up to 4× the approved dose of H1‐antihistamines plus H2‐antihistamines and/or leucotriene‐receptor antagonists. Objectives To highlight real‐life clinical practice in Taiwan and to understand the unmet medical needs of CSU patients. Methods A nationwide cross‐sectional, observational survey of 50 dermatologists and 200 CSU patients was conducted between June 2013 and November 2013. Face‐to‐face interviews of dermatologists and online interviews of CSU patients were conducted independently. Results Dermatologists reported that dermographism and blood tests were the most commonly used diagnostic methods to confirm the diagnosis. The key driving factor for most clinic‐based dermatologists (70%) in choosing a treatment was ‘response to my medicines’, and most preferred H1‐antihistamines and steroids for treating CSU patients, whereas most hospital‐based dermatologists (85%) gave higher priority to ‘severity and impact of the conditions’. Patients were reported to have high psychological pressures and significant impact of CSU on their daily activity. In addition, CSU patients were not satisfied with their current treatment and 69% of patients switched their first‐consulted physician. Furthermore, lack of information and concerns about side‐effects were major factors which held back patients from seeking Western treatment. Conclusions There is an unmet medical need of CSU patients in Taiwan highlighting gaps among guidelines, real‐life clinical practice, patients' perceptions and patients' knowledge of their disease.

The SPOT scores demonstrated the association of the paronychia severity with DLQI and pain. It may thus be useful in clinical practice and future studies.