Drug Induced Dermatologic Disorders Flashcards
1
Q
Maculopapular rash
A
- most common
- starts within 7-10days of drug initiation
- resolves within 7-14 days of stopping drug
2
Q
Dress (drug reaction w/ eosinophilia and systemic symptoms)
A
- Exanthematous eruption plus fever, lymphadenopathy, eosinophilia
- Delayed onset of 1-6 weeks after starting drug
3
Q
Allopurinol
A
Dress offending agent
4
Q
Sulfonamides
A
Dress offending agent
5
Q
Anticonvulsants-barbiturates
A
Dress offending agent
6
Q
Dapsone
A
Dress offending agent
7
Q
- Penicillins/ceph
- Sulfonamides
- Anticonvulsants
A
Maculopapular rash offending agents
8
Q
Dress treatment
A
- Stop offending agent
- Avoid starting any new meds
- No Organ involvement: high potency topical steroids, 2-3 times per day for 1 week
- Yes organ involvement: Systemic steroids prednisone, tapered over 8-12 weeks
9
Q
Urticaria
A
- Can be first sign of anaphylactic rxn
- Hives, pruritic red raised wheals
- Offending agents: Pen, sulfa, ASA, opiates, latex
10
Q
Serum Sickness-like reactions
A
- Urticaria, fever, arthralgia
- Onset 1-3 weeks after starting drug
- Offending agents: pen/ceph, sulfonamides
11
Q
Fixed drug eruptions
A
- Simple eruptions with pruritic, erythematous, raised lesions that can blister
- Recur in same area each time drug is given
- Onset within minutes-to-days with resolutions in days after drug d/c
- Offending agents: Tetracyclines, barbiturates, sulfonamides, codeine, Tylenol, NSAID
12
Q
SJS and TEN
A
- Skin lesions spread rapidly and cause epidermal, necrosis, detachment and sloughing
- Onset: within 7-14 days of drug exposure
- Risk factors: HIV, Lupus, Malignancy
13
Q
SJS/TEN offending agents
A
Sulfonamides, pen, anticonvulsants, NSAIDs, allopurinol
14
Q
SJS/TEN treatment
A
- Withdraw the offending agent
- Supportive care
- Wound care
- Ophthalmology consult
15
Q
Steroids for SJS/TEN
A
- May be beneficial when started within 24-48 hrs of symptom onset
- If it has been a week avoid them
- Do not use with TEN
16
Q
IVIG for SJS/TEN
A
-Possible benefit
17
Q
Cyclosporine
A
Possible benefit
18
Q
Thalidomide
A
don’t use for SJS/TEN
19
Q
Photosensitivity
A
-Offending agents: sulfonamides, tetracyclines, amiodarone, coal tar
20
Q
Cross reactivity
A
Pen and ceph cross reactivity is higher for 1st and 2nd gen ceph
