Cutaneous Drug Eruptions Flashcards
What is a cutaneous drug eruption
Adverse drug reaction of the skin
Give some examples of non immunological reactions
Eczema
Drug-induced alopecia
Photo-toxicity
Psoriasis
Pigmentation
Who is most likely to get a cutaneous drug eruption
Young female adults
Name some patient risk factors for drug eruptions
Genetic influence, concomitant disease, immune status
Name some concomitant diseases linked to drug eruptions
Viral infections: HIV, EBV, CMV
cystic fibrosis
Drug risk factors for a drug eruption
Chemistry, topical route, higher dose/longer half life
Give some examples of drug chemistry that are a risk for a drug eruption
B-lactam compounds, NSAIDs, high molecular weight
What is the most common type of drug reaction
Exanthematous
What type of allergic reaction is an exanthematous drug eruption
Type 4
What drugs are commonly associated with exanthematous drug reactions
Antibiotics, anti-epileptics, allopurinol, NSAIDs, chloramphenicol
When does an exanthematous drug eruption usually present
4-21 days after first taking the drug
Clinical presentation of an exanthematous drug reaction
Widespread, symmetrically distributed rash
Pruritus and mild fever are common
What kind of allergic reaction is a urticarial drug reaction
Type 1 hypersensitivity
When does a urticarial reaction usually occur
After rechallenge with a drug
What is another cause of a urticarial reaction
A direct release of inflammatory mediators from mast cells on first exposure
What is an acneiform drug reaction
Skin condition that looks like acne vulgaris but is induced by medications
Give some examples of drugs that can cause an acneiform drug eruptions
Glucocorticoids
Androgens
Lithium
Isoniazid
Phenytoin
Name some drugs that can cause AGEP
Antibiotics
CCBs
Anti-malarials
What is AGEP
Acute generalised exanthematous pustulosis
What causes drug-induced bullous pemphigoid
ACEi
Penicillin
Furosemide
What is a fixed drug eruption
Well demarcated, round plaques which recur at the same site a drug is taken and resolves with persistent pigmentation when you stop the drug
Where do fixed drug eruptions usually occur
Hands, genitalia, lips and occasionally the oral mucosa
How do fixed drug eruptions present
Eczematous lesions, papules, vesicles or urticaria
Name some drugs associated with fixed drug eruptions
Tetracycline
Doxycycline
Paracetamol
NSAIDs
Carbamazepine
What is DRESS
Drug reaction with eosinophilia and systemic symptoms
How does DRESS present
Widespread erythema, facial oedema, fever, lymphadenopathy and hepatosplenomegaly
When does DRESS usually present
2-6 weeks after initial exposure
Name some drugs associated with phototoxicity
Chlorpromazine
Quinine
Amiodarone
Doxycycline
Management of cutaneous drug reactions
Discontinue drug !!!
Topical corticosteroids
Antihistamines to help with itch
