Cutaneous Drug Eruptions Flashcards

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1
Q

define

A

dermatological presentation of a reaction to a drug

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2
Q

when does this reaction resolve?

A

when the drug is withdrawn

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3
Q

risk factors

A

age

immunosuppression

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4
Q

presentation

A
rash
urticaria
pigmentation
itch
pain
photosensitivity
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5
Q

diagnosis

A
history (consider drug most likely to cause eruption e.g. penicillin, time interval)
phototesting
biopsy
patch test
skin prick
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6
Q

when is skin testing not indicated?

A

serum sickness reactions (type 3) or T cell mediated reactions

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7
Q

why is skin testing not indicated in type 3 and 4 reactions?

A

can trigger Steven Johnson Syndrome (SJS), toxic epidermolysis necrosis (TEN) and DRESS (drug reaction with eosinophilia and systemic symptoms)

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8
Q

management

A
  • discontinue drug if possible and use alternative
  • topical corticosteroids
  • antihistamines
  • allergy bracelet
  • yellow card scheme
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9
Q

different types

A

immunologically cell-mediated reactions (allergic)
non-immunological reactions (non-allergic)
exanthematous drug eruptions
urticarial drug reactions (IgE mediated after rechallenge)
pustular or bullous drug eruptions
fixed drug eruptions
phototoxic drug reactions

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10
Q

drugs that cause acneiform eruptions

A
glucocorticoids 
androgens
lithium
isoniazid
phenytoin
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11
Q

drugs that cause acute generalised exanthematous pustulosis (AGEP)

A

antibiotics
CCBs
antimalarials

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12
Q

causes of drug-induced bullous pemphigoid

A

ACEIs
penicillin
furosemide

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13
Q

trigger for linear IgA disease

A

vancomycin

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14
Q

what type of reaction is exanthematous drug eruption?

A

T cell mediated delayed hypersensitivity (type 4)

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15
Q

presentation of exanthematous drug eruption

A

widespread symmetrical rash (can progress to a more serious systemic reaction)

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16
Q

presentation of fixed drug eruptions

A

well demarcated round plaques usually on hands, genitalia, lips and oral mucosa (often persistent pigmentation once the drug is stopped)

17
Q

drugs associated with fixed drug eruptions

A
tetracyclines
doxycycline
paracetamol
NSAIDs
carbamazepine
18
Q

what can cause an increased sensitivity to sunlight?

A

drugs
immunosuppression
lupus