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Differential diagnosis The diagnosis of DRESS syndrome remains complex due to a non-specific presentation, and, in children, it is even more challenging due to the numerous potential differential diagnoses, including a high number of infections (EBV, CMV, Parvovirus, Mycoplasma pneumoniae , and Staphylococcal Scalded Skin Syndrome), rheumatologic diseases (Kawasaki disease, systemic onset juvenile idiopathic arthritis, systemic lupus erythematosus), hematologic diseases (macrophage activation syndrome, hematologic malignancies, pseudolymphoma), and dermatological diseases (Stevens–Johnson syndrome, toxic epidermal necrolysis) (33, 37, 41)

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