Drug eruptions

Question 1

IMMUNOLOGIC MECHANISM of drug eruptions:

2.( cytotoxic drug-induced reactions )

Answer 1

• Petechiae 2ndary to drug-induced thrombocytopenia.

Question 2

How long does the lesion lasts in acute generalized exanthematous pustulosis (AGEP) ?

Answer 2

1-2 wks and are followed by a superficial desqumation.

Question 3

What are the two most common forms of cutaneous drug reactions ?

Answer 3

Exanthematous eruptions and urticaria.

Question 4

an acute,self limited skin disease characterised by the abrupt onset of symmetric fixed red papules, some of which evolves into typical and/or “atypical” papular TARGET LESION.

Answer 4

EM

Question 5

Which three most serious types of drug rashes ?

Answer 5

• Erythroderma.
• Toxic epidermal necrolysis (TEN).
• Anticonvulsant hypersensitivity syndrome.

Question 6

IMMUNOLOGIC MECHANISM of drug eruptions:

1. ( IgE-dependent drug reactions )

Answer 6

• Urticaria.
• Angioedema.
• Anaphylaxis.

Question 7

IMMUNOLOGIC MECHANISM of drug eruptions:

4.( cell-mediated reactions )

Answer 7

• Exanthematous.
• Fixed and lichenoid drug eruptions.
• SJS.
• TEN.
• Photo-allergic reaction.

Question 8

approximately 80% of drug induced pemphigus are due to ?

Answer 8

Drugs that contain a thiol group.

Question 9

Most important observation about drug-induced urticaria ?

Answer 9

• Central zone is normal skin.
• Lesions are transient, lasting less than 24 hrs.
• new lesions appears daily.
• Associated with swelling of the face.

Question 10

Which type of drug eruption is associated with Neutrophilia?

Answer 10

Sweet’s syndrome.

Question 11

IMMUNOLOGIC MECHANISM of drug eruptions:

3.( Immune complex-dependent )

Answer 11

• Vasculitis.
• Serum sickness.
• certain types of urticaria.

Question 12

What is the characteristic elementary skin lesion of EM ?

Answer 12

Typical target lesion.

Question 13

Sweet’s syndrome is characterized by ?

Answer 13

• Fever.
• Peripheral blood neutrophilia.
• Painful erythematous plaques.
• Favor face and upper extremities.
• Dense neutrophilic dermal infiltrate.
• in drug induced, neutrophilia is often absent.

Question 14

acute generalized exanthematous pustulosis (AGEP) ?

Answer 14

is an acute ferbile drug eruption characterized by numerous small, primarily non-follicular pustules, arising within large areas of Edematous erythema.

Question 15

Which type of drug eruption is associated with esoinophilia ?

Answer 15

DIHS (DRESS)

Question 16

Major drugs associated with Sweet’s syndrome are?

Answer 16

• All-trans-retinoic acid.

- G-CSF or GM-GSF

Question 17

What is the hallmark of DIHS ?

Answer 17

Edema of the face.

• fever and cutaneous eruptions are the most common symptoms.
• prominent eosinophilia is common and is a very characteristic feature.

Question 18

What is the major drugs that responsible for immunologically based urticaria ?

Answer 18

Antibiotics ( penicillin, cephalosporins and less common sulfonamide and tetracyclines )

Question 19

Major drugs associated with DIHS (DRESS) are?

Answer 19

• Anticonvulsants (phenytoin, carbamazapine, phenobarbital)

- Sulfonamide.

Question 20

Most important observation about drug-induced erythema multiforme ?

Answer 20

• Central zone is damaged skin. (dusky, bullous or crusted)
• Lesions “fixed” fo at least 7 days.
• All lesions appear within first 72 hrs.
• No edema.