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Thiamine is integral to the biochemistry of the nervous system, serving primarily as a coenzyme in key enzymatic reactions associated with energy metabolism, particularly the conversion of carbohydrates into usable energy (, , )

5).2 Extracutaneous manifestations The alarm signal for DRESS should be systemic involvement with affected internal organs, which can occur in up to 91% of patients, with liver involvement being the most common, followed by kidneys and lungs.15 Lymphadenopathy occurs in 50%75% of patients.34 Liver involvement due to DRESS occurs in up to 97% of cases, so it is the most common visceral manifestation

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