The first essential step in DRESS management is to:

• A. Stop offending agent
• B. Start systemic antibiotics
• C. Begin high-potency topical steroids
• D. Continue current meds

Answer: (A)

Discontinuing the drug that caused the reaction is the first and most crucial step. DRESS is a severe hypersensitivity to a medication, and continuing exposure to the offending agent allows the immune reaction to persist and can lead to worsening organ involvement and higher mortality. By stopping the triggering drug, you remove the primary cause of the syndrome, which is the essential action that enables safe further management. After withdrawal, assess for organ involvement and consider systemic corticosteroids if there is significant organ impact, while providing supportive care. Starting antibiotics without evidence of infection, applying only topical steroids, or continuing the current medications do not address the underlying trigger and can allow the reaction to progress.