DRESS Syndrome

A 38-year-old woman on allopurinol for gout presents with a 2-week history of fever (39°C), a widespread pruritic rash involving the face, trunk, and flexural areas, and cervical lymphadenopathy. Laboratory investigations show WBC 12,000/μL with 18% eosinophils, elevated transaminases (AST 120 U/L, ALT 140 U/L), and atypical lymphocytes on blood smear. Skin biopsy shows perivascular lymphocytic infiltration with eosinophils. Which of the following is the most appropriate immediate management?

A 35-year-old woman presents with fever, facial edema, and a widespread erythematous maculopapular rash that began 3 weeks after starting carbamazepine for newly diagnosed epilepsy. Laboratory investigations reveal: WBC 12,000/μL with 15% atypical lymphocytes, ALT 180 U/L, AST 165 U/L, and mild lymphadenopathy on examination. Which of the following is the most appropriate immediate management?

A 28-year-old man presents with fever, generalized lymphadenopathy, and a pruritic maculopapular rash over the trunk and extremities that began 3 weeks after starting phenytoin for newly diagnosed seizures. Laboratory investigations show WBC 12,000/μL with atypical lymphocytes, elevated transaminases (ALT 280 U/L), and mild thrombocytopenia. Which of the following is the most appropriate immediate management?