Types + Most frequent Causes of Drug Erruptions

Question 1

What can drugs be

Answer 1

• Toxic
• Carcinogenic
• Teratogenics
• Allergic Re-activation

Question 2

What type of Skin rash can arise due to drugs

Answer 2

Any type

Question 3

Adverse Cutaneous Drug Reactions

Answer 3

• relatively common in hospital ptnts (2-3%)
• must be considered in DDz of any sudden symmetrical Erruption
• Most are Mild –> Widespread Maculopapular Rashes with Pruritus
• Most resolve after Discontinuing the Drug

Question 4

ACDR caused by

Answer 4

1) Immunologic Rxn
2) Non-immunologic Rxn

*may be provoked by systemic/topical application

Question 5

Fixed Drug Erruption

Answer 5

ACDR which occur at specific sites

Question 6

Common offenders causing ACDR

Answer 6

• ABC

- Chemotherapy

Question 7

Findings indicating Possible threatening ACDR

Answer 7

1) Confluent Erythema
2) Facial Edema/ Central Facial Involvement
3) Skin Pain/Necrosis
4) Positive Nikolsky’s Sign (epidermis seperates from dermis via lateral pressure
5) Mucus Membrane Erosions
6) Urticaria
7) Swelling of Tongue

• fever >40deg
• Arthiritis/Hypotension
• Enlarged LN
• SOB

Question 8

Most Serious Drug Rashes

Answer 8

1) Erythoderma (Exfoliative Dermatitis)
2) TEN
3) Anti-convulsant HS Syndrome

Question 9

Erythoderma

Answer 9

Clinical condition with Redness/Inflmm of all Skin

Accompanied with:

• Pruritus
• Tightness Sensation of Skin
• Systemic Signs (Fever/Malaise/LAP)

Question 10

Toxic Epidermal Necrolysis

Answer 10

-widespread subepidermal blistering and sloughing of most of the skin
(itching + burning sensation)

• Fever + Mucosal Involvement (including internal epitheliium)
• Multi-organ failure / Sepsis

Question 11

Anticonvulsant HS Syndrome

Answer 11

-generalized mucocutaneous rash (fever/LAP)

sometimes:

• SM
• Pharyngitis
• Periorbital Edema
• pulsation can occur
• can progress to multi-organ failure