Drug Eruptions

Question 1

EXANTHEMATOUS DRUG REACTION

Answer 1

weigh risks and benefits of drug discontinuation

• antihistamines, emollients, topical steroids

Question 2

DRUG INDUCED HYPERSENSITIVITY SYNDROME (DIHS) / DRUG REACTION WITH
EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS)

Answer 2

Management
• discontinue offending drug ± prednisone 0.5mg/kg/d, consider cyclosporine in severe cases
• may progress to generalized exfoliative dermatitis/erythroderma if drug is not discontinued

Question 3

DRUG INDUCED URTICARIA AND ANGIOEDEMA

Answer 3

discontinue offending drug, treatment with antihistamines, steroids, epinephrine if anaphylactic

Question 4

SERUM SICKNESS-LIKE REACTION

Answer 4

discontinue offending drug ± topical/oral corticosteroids

Question 5

ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS (AGEP)

Answer 5

discontinue offending drug and systemic corticosteroids

Question 6

STEVEN-JOHNSON SYNDROME (SJS)/TOXIC EPIDERMAL NECROLYSIS (TEN)

Answer 6

discontinue offending drug
• admit to intermediate/intensive care/burn unit
• supportive care: IV fluids, electrolyte replacement, nutritional support, pain control, wound care, sterile
handling, monitor for and treat infection
• IVIg or cyclosporine or etanercept

Question 7

FIXED DRUG ERUPTION

Answer 7

discontinue oending drug ± prednisone 1mg/kg/d x 2 wk for generalized lesions ± potent topical
corticosteroids for non-eroded lesions or antimicrobial ointment for eroded lesions

Question 8

PHOTOSENSITIVITY REACTION

Answer 8

• sun protection ± topical/oral corticosteroids