# RegiSCAR DRESS score (Kardaun 2007)

RegiSCAR

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/regiscar`
HTML: https://magentlab.com/docs/regiscar
Markdown: https://magentlab.com/docs/regiscar.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Sum the ten Kardaun 2007 RegiSCAR DRESS scoring-letter items from caller-assigned flags, eosinophilia grade, and organ count, and return the −4 to 9 total and the published none/possible/probable/definite band.

## When to use

When an agent has already assigned the Kardaun 2007 scoring-letter items and needs the published total and validation band. magent does not count eosinophils, read a biopsy, measure BSA, or diagnose DRESS.

## When not to use

- Not a medical device and not a DRESS diagnosis.
- magent does not count eosinophils or read a biopsy. Each item is caller-assigned. Biopsy unknown is not offered: biopsy_compatible must be true (0) or false (−1).
- Not SCORTEN and not J-SCAR.
- Scoring is the Kardaun 2007 Br J Dermatol scoring letter, not the 2013 prospective series.

## Formula

```
RegiSCAR = fever_ge_38_5 (true 0, false −1) + lymphadenopathy_ge_2_sites (true 1, false 0) + eosinophilia (none 0, mild 1, severe 2) + atypical_lymphocytes (true 1, false 0) + rash_gt_50_bsa (true 1, false 0) + rash_suggestive (true 1, false −1) + biopsy_compatible (true 0, false −1) + organs (0/1/≥2 → 0/1/2) + resolution_ge_15_days (true 0, false −1) + alternative_causes_excluded (true 1, false 0); Kardaun 2007 scoring letter; sum −4 to 9; none <2, possible 2–3, probable 4–5, definite ≥6
```

## Citation

[Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?](https://doi.org/10.1111/j.1365-2133.2006.07704.x)
Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, Roujeau JC
Br J Dermatol. 2007;156(3):609-611
DOI: [10.1111/j.1365-2133.2006.07704.x](https://doi.org/10.1111/j.1365-2133.2006.07704.x)

## Worked example

### Worked example scores −1 none

Given: `alternative_causes_excluded=false, atypical_lymphocytes=false, biopsy_compatible=true, eosinophilia=none, fever_ge_38_5=true, lymphadenopathy_ge_2_sites=false, organs=0, rash_gt_50_bsa=false, rash_suggestive=false, resolution_ge_15_days=true`

1. fever_ge_38_5 true → 0; lymphadenopathy_ge_2_sites false → 0; eosinophilia none → 0; atypical_lymphocytes false → 0; rash_gt_50_bsa false → 0
2. rash_suggestive false → −1; biopsy_compatible true → 0; organs 0 → 0; resolution_ge_15_days true → 0; alternative_causes_excluded false → 0
3. Score = −1 (max 9); regiscar_band none


## Also searched as

- RegiSCAR DRESS
- Kardaun 2007
- DRESS validation score
- drug reaction with eosinophilia
- RegiSCAR score
- DRESS syndrome score
- Kardaun scoring letter
- cutaneous drug reaction score

## Parameters

- `fever_ge_38_5` (boolean, required): Caller-assigned fever ≥38.5 °C (Kardaun 2007). true scores 0; false scores −1. magent does not measure temperature.
- `lymphadenopathy_ge_2_sites` (boolean, required): Caller-assigned lymphadenopathy involving ≥2 sites (Kardaun 2007). true scores 1; false scores 0. magent does not examine lymph nodes.
- `eosinophilia` (string, required): Caller-assigned eosinophilia (Kardaun 2007): none (0), mild (1; 700–1499/µL or 10–19%), or severe (2; ≥1500/µL or ≥20%). magent does not count eosinophils.
- `atypical_lymphocytes` (boolean, required): Caller-assigned atypical lymphocytes (Kardaun 2007). true scores 1; false scores 0. magent does not read a blood film.
- `rash_gt_50_bsa` (boolean, required): Caller-assigned rash extent >50% body surface area (Kardaun 2007). true scores 1; false scores 0. magent does not measure BSA.
- `rash_suggestive` (boolean, required): Caller-assigned rash morphology suggestive of DRESS (Kardaun 2007). true scores 1; false scores −1. magent does not examine the skin.
- `biopsy_compatible` (boolean, required): Caller-assigned skin-biopsy compatibility with DRESS (Kardaun 2007). true scores 0; false scores −1. Unknown is not offered. magent does not read a biopsy.
- `organs` (integer, required): Caller-assigned organ involvement count (Kardaun 2007): integer 0, 1, or 2 (≥2 organs scores 2). Values outside 0–2 are rejected. magent does not diagnose organ injury.
- `resolution_ge_15_days` (boolean, required): Caller-assigned resolution ≥15 days (Kardaun 2007). true scores 0; false scores −1. magent does not time the illness.
- `alternative_causes_excluded` (boolean, required): Caller-assigned exclusion of alternative causes (Kardaun 2007). true scores 1; false scores 0. magent does not exclude infection or other diagnoses.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/regiscar`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "alternative_causes_excluded": "false",
      "atypical_lymphocytes": "false",
      "biopsy_compatible": "true",
      "eosinophilia": "none",
      "fever_ge_38_5": "true",
      "lymphadenopathy_ge_2_sites": "false",
      "organs": "0",
      "rash_gt_50_bsa": "false",
      "rash_suggestive": "false",
      "resolution_ge_15_days": "true"
    },
    {
      "alternative_causes_excluded": "false",
      "atypical_lymphocytes": "false",
      "biopsy_compatible": "true",
      "eosinophilia": "none",
      "fever_ge_38_5": "true",
      "lymphadenopathy_ge_2_sites": "false",
      "organs": "0",
      "rash_gt_50_bsa": "false",
      "rash_suggestive": "false",
      "resolution_ge_15_days": "true"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/regiscar

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/regiscar",
  "items": [
    {
      "components": [
        {
          "value": true,
          "factor": "fever_ge_38_5",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "lymphadenopathy_ge_2_sites",
          "points": 0,
          "present": true
        },
        {
          "value": "none",
          "factor": "eosinophilia",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "atypical_lymphocytes",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "rash_gt_50_bsa",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "rash_suggestive",
          "points": -1,
          "present": true
        },
        {
          "value": true,
          "factor": "biopsy_compatible",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "organs",
          "points": 0,
          "present": true
        },
        {
          "value": true,
          "factor": "resolution_ge_15_days",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "alternative_causes_excluded",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, Roujeau JC",
        "doi": "10.1111/j.1365-2133.2006.07704.x",
        "id": "kardaun-2007",
        "pmid": "17300272",
        "source": "Br J Dermatol. 2007;156(3):609-611",
        "title": "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?"
      },
      "formula": "regiscar",
      "formula_expression": "RegiSCAR = fever_ge_38_5 (true 0, false −1) + lymphadenopathy_ge_2_sites (true 1, false 0) + eosinophilia (none 0, mild 1, severe 2) + atypical_lymphocytes (true 1, false 0) + rash_gt_50_bsa (true 1, false 0) + rash_suggestive (true 1, false −1) + biopsy_compatible (true 0, false −1) + organs (0/1/≥2 → 0/1/2) + resolution_ge_15_days (true 0, false −1) + alternative_causes_excluded (true 1, false 0); Kardaun 2007 scoring letter; sum −4 to 9; none <2, possible 2–3, probable 4–5, definite ≥6",
      "max_score": 9,
      "score": -1,
      "regiscar_band": "none"
    },
    {
      "components": [
        {
          "value": true,
          "factor": "fever_ge_38_5",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "lymphadenopathy_ge_2_sites",
          "points": 0,
          "present": true
        },
        {
          "value": "none",
          "factor": "eosinophilia",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "atypical_lymphocytes",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "rash_gt_50_bsa",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "rash_suggestive",
          "points": -1,
          "present": true
        },
        {
          "value": true,
          "factor": "biopsy_compatible",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "organs",
          "points": 0,
          "present": true
        },
        {
          "value": true,
          "factor": "resolution_ge_15_days",
          "points": 0,
          "present": true
        },
        {
          "value": false,
          "factor": "alternative_causes_excluded",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, Roujeau JC",
        "doi": "10.1111/j.1365-2133.2006.07704.x",
        "id": "kardaun-2007",
        "pmid": "17300272",
        "source": "Br J Dermatol. 2007;156(3):609-611",
        "title": "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?"
      },
      "formula": "regiscar",
      "formula_expression": "RegiSCAR = fever_ge_38_5 (true 0, false −1) + lymphadenopathy_ge_2_sites (true 1, false 0) + eosinophilia (none 0, mild 1, severe 2) + atypical_lymphocytes (true 1, false 0) + rash_gt_50_bsa (true 1, false 0) + rash_suggestive (true 1, false −1) + biopsy_compatible (true 0, false −1) + organs (0/1/≥2 → 0/1/2) + resolution_ge_15_days (true 0, false −1) + alternative_causes_excluded (true 1, false 0); Kardaun 2007 scoring letter; sum −4 to 9; none <2, possible 2–3, probable 4–5, definite ≥6",
      "max_score": 9,
      "score": -1,
      "regiscar_band": "none"
    }
  ]
}
```

## Response fields

- `formula` (string): regiscar
- `formula_expression` (string): Exact expression used
- `score` (integer): Kardaun 2007 RegiSCAR DRESS points −4 to 9
- `max_score` (integer): Always 9
- `regiscar_band` (string): Published validation band: none (<2), possible (2–3), probable (4–5), or definite (≥6). Not a DRESS diagnosis.
- `components` (array): Per-item caller-assigned points
- `citation` (object): Kardaun 2007 Br J Dermatol scoring-letter citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": true,
      "factor": "fever_ge_38_5",
      "points": 0,
      "present": true
    },
    {
      "value": false,
      "factor": "lymphadenopathy_ge_2_sites",
      "points": 0,
      "present": true
    },
    {
      "value": "none",
      "factor": "eosinophilia",
      "points": 0,
      "present": true
    },
    {
      "value": false,
      "factor": "atypical_lymphocytes",
      "points": 0,
      "present": true
    },
    {
      "value": false,
      "factor": "rash_gt_50_bsa",
      "points": 0,
      "present": true
    },
    {
      "value": false,
      "factor": "rash_suggestive",
      "points": -1,
      "present": true
    },
    {
      "value": true,
      "factor": "biopsy_compatible",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "organs",
      "points": 0,
      "present": true
    },
    {
      "value": true,
      "factor": "resolution_ge_15_days",
      "points": 0,
      "present": true
    },
    {
      "value": false,
      "factor": "alternative_causes_excluded",
      "points": 0,
      "present": true
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, Roujeau JC",
    "doi": "10.1111/j.1365-2133.2006.07704.x",
    "id": "kardaun-2007",
    "pmid": "17300272",
    "source": "Br J Dermatol. 2007;156(3):609-611",
    "title": "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?"
  },
  "formula": "regiscar",
  "formula_expression": "RegiSCAR = fever_ge_38_5 (true 0, false −1) + lymphadenopathy_ge_2_sites (true 1, false 0) + eosinophilia (none 0, mild 1, severe 2) + atypical_lymphocytes (true 1, false 0) + rash_gt_50_bsa (true 1, false 0) + rash_suggestive (true 1, false −1) + biopsy_compatible (true 0, false −1) + organs (0/1/≥2 → 0/1/2) + resolution_ge_15_days (true 0, false −1) + alternative_causes_excluded (true 1, false 0); Kardaun 2007 scoring letter; sum −4 to 9; none <2, possible 2–3, probable 4–5, definite ≥6",
  "max_score": 9,
  "score": -1,
  "regiscar_band": "none"
}
```

## Errors

- HTTP 400 `invalid_regiscar`: RegiSCAR items must use the published Kardaun 2007 values (fever/lymphadenopathy/atypical_lymphocytes/rash flags; eosinophilia none, mild, or severe; organs 0-2; resolution_ge_15_days; alternative_causes_excluded). Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [SCORTEN](https://magentlab.com/docs/scorten) — Sum the seven Bastuji-Garin 2000 SCORTEN risk factors from caller-assigned flags and return the 0–7 score and that paper's predicted in-hospital mortality token.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.