Cutaneous Drug Reactions

Question 1

What are the different types of cutaneous drug reactions?

Answer 1

Maculopapular rash
Fixed drug rash
Urticaria +/- angioedema
Severe cutaneous drug reactions
      SJS / TEN
      DRESS
      Erythroderma
      Acute generalised erythematous pustulosis

Question 2

What is DRESS?

Answer 2

A severe cutaneous drug reaction where there is widespread erythema, facial oedema, fever, lymphadenopathy, hepatomegaly, eosinophilia,
It starts 2-6 weeks after drug exposure and is treated with corticosteroids

Question 3

What is acute generalised erythematous pustulosis?

Answer 3

A severe cutaneous drug reaction where there are small, non-follicular sterile pustules on the neck, axillae and groin, It starts within days of drug exposure and is treated with topical steroids and emollients.

Question 4

What strategy can be used in the diagnosis of cutaneous drug reactions?

Answer 4

Challenge, dechallenge and re challenge

Question 5

What investigative tests should be conductive for likely cutaneous drug reactions?

Answer 5

Complement 4 if urticaria / angioedema present
Serum tryptase (if anaphylaxis present, it will be increase)
FBC ( to differentiated between drug-induced lupus and SLE)
Skin biopsy (not always required)