Drug Eruptions Flashcards
Severe cutaneous adverse drug reactions
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Drug reaction with eosinophilia and systemic symptoms (DRESS)
Acute generalised exathematous pustulosis (AGEP)`
Type of drug eruptions
Exathematous/morbilliform/maculopapular
Urticarial drug reactions
Papulosquamous/pustular/bullous reactions
Fixed drug eruptions
Stevens-Johnson syndrome and toxic epidermal necrolysis
Drug reaction with eosinophilia and systemic symptoms (DRESS)
Phototoxic drug reactions
Presentation of exathematous/morbilliform/maculopapular drug eruption
Rash starts on the torso, spreads to the face and limbs
Mucosae is spared
Itch, fever
Self-limiting (1-2wks)
2wks after onset of therapy
Can progress to a life-threatening reaction
Drugs causing exathematous/morbilliform/maculopapular drug eruption
Penicillins Sulphonamides Erythromycin Streptomycin Allopurinol Anti-epileptics NSAIDS Chloramphenicol
What is the most common type of hypersensitivity rash?
Exathematous/morbilliform/maculopapular
Mechanism of urticarial drug reactions
IgE-mediated
Drug-induced mast degranulation
Presentation of urticarial drug reactions
Rapid onset after taking the drug
Wheals +/- associated angioedema or anaphylaxis
Drugs causing IgE-mediated urticarial drug reactions
B-lactam antibiotics (amoxicillin)
Carbamazepine
Drugs causing drug-induced mast degranulation urticarial drug reactions
Aspirin Opiates NSAIDS Muscle relaxants Vancomycin Quinolones
Types of papulosquamous/pustular/bullous drug eruptions
Acneiform
Acute generalised exanthematous pustulosis (AGEP)
Drug-induced bullous pemphigoid
Drugs causing acneiform drug eruptions
Glucocorticoids Androgens Lithium Isoniazid Phenytoin
Drugs causing drug acute generalised exanthematous pustulosis eruptions
Superficial pustules (neck, axillae, groin)
Presentation of fixed drug eruptions
Inflamed patches that recur at the same site each time a drug is taken
They may blister and often resolve with hyperpigmentation
Drugs causing fixed drug eruptions
Tetracycline Doxycycline NSAIDS Carbamazepine Amoxicillin
Presentation of Stevens-Johnson syndrome and toxic epidermal necrolysis
1-2wks after drug exposure
Initial non-specific symptoms (malaise, myalgia, fever, cough)
TEN: blistering with skin that wrinkles like wet wallpaper on gentle pressure
Drugs causing Stevens-Johnson syndrome and toxic epidermal necrolysis
Sulfonamides Cephalosporins Carbamazepine Phenytoin NSAIDs Nevirapine Lamotrigine Sertraline Pantoprazole Tramadol
Presentation of drug reaction with eosinophilia and systemic symptoms
2-6wks after drug exposure Widespread erythema Facial oedema Fever Lymphadenopathy Hepatosplenomegaly Blood eosinophilia
Drugs causing drug reaction with eosinophilia and systemic symptoms
Sulfonamides Anticonvulsants Allopurinol Minocycline Dapsone NSAIDs Abacavir Nevirapine Vancomycin
Phototoxic drug reactions
Non-immunological skin reaction causing increased sensitivity to light
Caused by exposure to photo-reactive drugs
Presentation of phototoxic drug reactions
Unexpected sunburn or dermatitis on sun exposed skin
Drugs that cause phototoxic drug reactions
Antibiotics Thiazides Chloropromazine NSAIDs Quinine Psoralens Amiodarone Porphyrins BRAF inhibitors Antifungals Immunosuppressants
