Drug Eruptions

Question 1

Maculopapular drug eruptions

What drugs, characteristic (onset, duration, pruritic or non?)

Answer 1

Penicillins, cephalosporins, sulfonamides, carbamazepines, hydantoins, allopurinol, and gold
characteristics:
Most common. Similar to viral exanthems. Typically begin 7-10 days after a patient is started on the drug and fades over 1-2 weeks. Typically pruritic.

Question 2

Uncomplicated Urticaria

what drugs, rrash description

Answer 2

Aspirin, penicillin, and NSAIDS

Itchy red, erythematous plaques that are evanescent.

Question 3

Photosensitivity

what drugs, rash description

Answer 3

Thiazides, tetracyclines, methotrexate, sulfonamides

Sunburn reaction or sun sensitivity.

Question 4

Acneiform

what drugs, rash description

Answer 4

Hormones,
lithium,
phenobarbital,
phenytoins and
iodides

Mimic acne, but without the comedones.

Question 5

Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis

what drugs, rash description

Answer 5

Sulfonamides and anticonvulsants
Spectrum of adverse drug reaction: SJS is defined as affecting < 10% BSA epidermal detachment. TEN is defined as affecting > 30% BSA epidermal detachment. SJS/TEN overlap 10-30% BSA epidermal detachment (Widespread erythematous or purpuric macules or flat atypical target lesions mucous membrane involvement including conjunctiva, genital and urinary tract, upper respiratory tract, and GI tract. Histology shows epidermal necrolysis).

Question 6

Serum sickness

what drugs, rash description- timing/ associated sxs

Answer 6

Aspirin, penicillin, sulfonamides, thiouracils, and streptomycin
`Urticaria occurring day 4-21. Associated with circulating immune complexes. Associated with hematuria, lymphadenopathy, fever, and arthralgia.

Question 7

Anaphylaxis

MC drugs, timing, assoicated sxs

Answer 7

Penicillins (most common),cephalosporins

Occur within minutes to hours. IgE-mediated. Urticarial rash. Associated with shock, bronchospasm.