Drug eruptions: urticarial

Question 1

Urticarial

what kinds do they are?

Answer 1

DRUG INDUCED URTICARIA AND ANGIOEDEMA
and
SERUM SICKNESS-LIKE REACTION

Question 2

DRUG INDUCED URTICARIA AND ANGIOEDEMA
Clinical Feature
• morphology:

Answer 2

• morphology: wheals lasting >24 h unlike non-drug induced urticaria, angioedema (face and mucous
membranes)

Question 3

DRUG INDUCED URTICARIA AND ANGIOEDEMA

systemic features

Answer 3

may be associated with systemic anaphylaxis (bronchospasm, laryngeal edema, shock)

Question 4

DRUG INDUCED URTICARIA AND ANGIOEDEMA

time course:

Answer 4

h-d after exposure depending on the mechanism

Question 5

DRUG INDUCED URTICARIA AND ANGIOEDEMA

Epidemiology

Answer 5

second most common cutaneous drug reaction

Question 6

DRUG INDUCED URTICARIA AND ANGIOEDEMA

common causative agents:

Answer 6

penicillins, ACEI, analgesics/anti-inflammatories, radiographic contrast media

Question 7

DRUG INDUCED URTICARIA AND ANGIOEDEMA

Management

Answer 7

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

Question 8

SERUM SICKNESS-LIKE REACTION

Clinical Feature morphology:

Answer 8

symmetrical cutaneous eruption (usually urticarial)

•

Question 9

SERUM SICKNESS-LIKE REACTION systemic features

Answer 9

malaise, low grade fever, arthralgia, lymphadenopathy

•

Question 10

SERUM SICKNESS-LIKE REACTION time course

Answer 10

appears 1-3 wk after drug initiation, resolve 2-3 wk after withdrawal

Question 11

SERUM SICKNESS-LIKE REACTION Epidemiology

Answer 11

more prevalent in kids (0.02-0.2%)

Question 12

SERUM SICKNESS-LIKE REACTION • common causative agents:

Answer 12

cefaclor in kids; bupropion in adults

Question 13

SERUM SICKNESS-LIKE REACTION Management

Answer 13

discontinue oending drug ± topical/oral corticosteroids