Drug Induced Skin Reactions Flashcards
Immediate Drug Reactions
- Urticaria
- Angioedema
- Anaphylaxis
Delayed Drug Reactions
- Morbilliform Eruptions
- Fixed Drug Eruptions
- SJS
- TEN
- Vasculitis
Exanthematous Drug Eruption
- Type
Type 4 Delayed Hypersensitivity
Exanthematous Drug Eruption
- Presentation
Morbilliform rash begins on trunk and upper extremities (Pink and red spots)
- Spreads and merges to form large patches
Exanthematous Drug Eruption
- Causative Agents
- Penicillins
- Sulfonamides
- Cephalosporins
- Anticonvulsants
Exanthematous Drug Eruption
- Treatment
Stop the agent
- Resolves on own after 2 weeks
- Symptom relief (Topical steroids)
Urticarial Eruptions
- Type
Type 1 IgE Dependent Drug Reaction
Urticarial Eruptions
- Presentation
- Any body site
- Itchy and burning
- Spontaneous appearance and resolution
Urticarial Eruptions
- Causative Agent
Antibiotics
Urticarial Eruptions
- Treatment
Stop the drug
Oral antihistamine
Fixed Drug Eruption
- Type
Type 4 Delayed Hypersensitivity
Fixed Drug Eruption
- Presentation
Formation of round / oral shaped patches
- May blister
Fixed Drug Eruption
- Causative Agent
Tetracycline
Sulfonamide
NSAIDs
Pseudoephedrine
Fixed Drug Eruption
- Treatment
Discontinue drug
Avoid drug
Topical steroid / Systemic corticosteroid
Generalized blisters require intensive care or burn wound care
DRESS
- Type
Idiosyncratic
Stands for:
- Drug Reaction with Eosinophilia and Systemic Symptoms
DRESS
- Presenation
Morbilliform Rash and systemic symptoms
- Blisters as well
Multiple organ involvement
DRESS
- Causative Agents
Anticonvulsants
Antibiotics
Antiretrovirals
Allopurinol
NSAIDs
DRESS
- Treatment
Tapering of Systemic Corticosteroids
Extensive monitoring
SJS
- Type
Type IV Hypersensitivity Reaction
Stands for:
- Steven Johnshon Syndrome
SJS
- Presentation
Symptoms like URTI before developing into a rash
- Blister development
- Blisters merge to form sheets of skin detachment
SJS
- Causative Agents
Anti-Inflammatory
Allopurinol
Anticonvulsants
Sulfonamides
SJS
- Treatment
Discontinue the drug
Systemic Corticosteroids (Dexamethasone)
SJS
- TEN
SJS: < 10% BSA epidermal detachment
TEN: >30% BSA epidermal detachment
Types of Photosensitivity
Photoxic (Most Common)
- Sunburn like
- Sun exposed sites
Photoallergic
- Eczematous
- Sun and non sun exposed sites
- Secondary to drugs and hypersensitivity
