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Dermatology > Drug Reactions > Flashcards

Drug Reactions Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the most common type of drug reaction

A

Exanthematous drug reaction

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2
Q

Presentation of exanthematous drug reaction

A

erythematous confluent macules

Fever

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3
Q

timeline of exanthematous drug reaction

A

anytime up to 2-3 weeks after administration

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4
Q

drugs causing an exanthematous reaction

A

penicillins
carbamazepine
NSAIDs
allopurinol

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5
Q

What is drug-induced urticaria

A

drug-induced hives - skin reaction causing itchy welts and blotches

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6
Q

What life-threatening symptoms can drug-induced urticaria occur with

A

angioedema

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7
Q

timeline of drug-induced urticaria

A

within 36h of administration

within minutes on re-challenging with the drug

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8
Q

drugs causing drug-induced urticaria

A

penicillins
NSAIDs
ACEi
CCBs

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9
Q

What is erythema multiforme

A

target lesions usually on extensor surfaces

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10
Q

erythema multiforme can be caused by drugs, but what is the most common cause

A

HSV

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11
Q

drug causes of erythema multiforme

A 
sulphonamides (e.g. co-trimoxazole)
penicillin 
phenytoin 
allopurinol 
carbamzaepine 
NSAIDs
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12
Q

What is Steven Johnson Syndrome (SJS)

A

major variant of erythema multiforme that involves epidermal and mucosal blistering

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13
Q

What % of epidermal blistering is there in SJS

A

<10% of epidermal detachment

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14
Q

Presentation of SJS

A

fever & flu-like symptoms
then,
epidermal blistering
mucosal blistering

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15
Q

Drugs causing SJS

A

allopurinol
sulphonamides
anticonvulsants
NSAIDs

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16
Q

Pathogenesis of SJS

A

deficiency in enzymes required for drug detoxifications, which then triggers an immune response in the skin

Normally - apoptotic cells are eliminated by phagocytes

SJS - apoptotic rate is increased, so cells accumulate and become necrotic, which triggers an inflammatory response

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17
Q

timeline of SJS

A

lesions usually occur 2-8 weeks after ingestion of drugs

18
Q

What is Toxic Epidermal Necrolysis (TENS)

A

severe form of SJS (along a spectrum) that involves keratinocyte necrosis with epidermal and mucosa detachment

19
Q

What % of epidermal blistering is there in TENS

A

> 30%

20
Q

Presentation of TENS

A

fever & flu-like symptoms
then,
epidermal blistering
mucosal blistering

dehydration
conjunctivitis

(basically like SJS but more severe)

21
Q

Drugs causing TENS

A

allopurinol
sulphonamides
anticonvulsants
NSAIDs

22
Q

Tx TENS and SJS

A

removal of offending drug

fluid replacement

temperature maintenance (warm room)

pain relief

23
Q

what is SJS/TENS overlap

A

epidermal detachment between 10-30%

24
Q

What is hypersensitivity vasculitis

A

A cutaneous small vessel vasculitis caused by a drug

25
Q

Presentation of hypersensitivity vasculitis

A

Presents like small vessel vasculitis

26
Q

Timeline of hypersensitivity vasculitis

A

7-10 days after administration

27
Q

Drugs causing hypersensitivity vasculitis

A 
allopurinol 
amiodarone 
NSAIDs 
Thiazides 
Penicillins 
Sulphonamides 
Hydralazine
28
Q

What is erythroderma

A

A descriptive term that means a widespread scaly erythematous rash covering >90% of body surface area.

29
Q

What is erythroderma also known as

A

exfoliative dermatitis

30
Q

drugs causing erythroderma

A

barbituates
gold
quinine
sulphonamides

31
Q

General causes of erythema nodosum

A 
Strep 
TB 
Leprosy 
Sarcoidosis 
UC 
Behcet's syndrome 
Idiopathic 
Drugs
32
Q

Drugs causing erythema nodosum

A

Sulphonamides

OCP

33
Q

What is a fixed drug eruption

A

Well-demarcated round/ovoid plaques that occur at the same sites on exposure to the drug

34
Q

Common sites for a fixed drug eruption

A

hands, feet, genitalia

35
Q

drugs caused a fixed drug eruption

A

tetracyclines
NSAIDs
quinine
OCP

36
Q

Drugs causing a drug-induced lichenoid eruption

A

B blockers
Captopril Thiazides
Furosemide

37
Q

Drugs causing drug-induced pemphigoid

A

Furosemide
Penicillamine
Penicillin
Sulphasalazine

38
Q

Drugs causing drug-induced pemphigus

A

Penicillamine
Captopril
Penicillin Gold

39
Q

Drugs causing drug-induced photosensitivity

A

Quinine
Thiazide
Doxycycline

40
Q

Appearance of drug-induced lupus

A

Anular rash on sun exposed areas

41
Q

Drugs causing drug-induced lupus

A 
Hydralazine 
Procainamide 
B blockers 
Phenytoin 
Thiazides
42
Q

Drugs causing drug induced hyperpigmentation

A

Chlorpromazine

Dermatology (20 decks)

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