Drug eruption: Difference between revisions

Revision as of 10:56, 15 February 2025

An adverse reaction to a medication manifesting on the skin

Overview

A drug eruption is a type of adverse drug reaction that manifests as a skin condition. These eruptions can vary widely in appearance and severity, ranging from mild rashes to severe, life-threatening conditions. Drug eruptions are a common reason for dermatological consultations and can be caused by a wide variety of medications.

Pathophysiology

Drug eruptions occur when the body's immune system reacts to a medication. This reaction can be mediated by different immunological mechanisms, including IgE-mediated hypersensitivity, T-cell mediated reactions, and immune complex formation. The specific mechanism often determines the type and severity of the eruption.

Types of Drug Eruptions

Exanthematous Eruptions

Exanthematous eruptions, also known as maculopapular rashes, are the most common type of drug eruption. They typically appear as widespread red spots and bumps on the skin and are usually symmetrical. These eruptions are often benign and resolve after discontinuation of the offending drug.

Urticarial Eruptions

Urticaria, or hives, are raised, itchy welts on the skin that can be caused by drug reactions. These eruptions are often associated with IgE-mediated hypersensitivity and can occur rapidly after drug exposure.

Fixed Drug Eruptions

A fixed drug eruption is characterized by a well-defined, round or oval patch that recurs at the same site each time the drug is taken. These lesions can be red, purple, or brown and may blister.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe, life-threatening drug eruptions. They involve widespread skin detachment and mucous membrane involvement. These conditions require immediate medical attention and often hospitalization.

Diagnosis

The diagnosis of a drug eruption is primarily clinical, based on the patient's history and the appearance of the skin lesions. A detailed medication history is crucial, including over-the-counter drugs and supplements. In some cases, skin biopsy or patch testing may be used to confirm the diagnosis.

Management

The primary treatment for drug eruptions is the discontinuation of the offending medication. Supportive care, such as antihistamines for itching or corticosteroids for inflammation, may be provided. In severe cases, such as SJS or TEN, hospitalization and intensive care may be necessary.

Prevention

Preventing drug eruptions involves careful prescribing practices, including reviewing patient allergies and previous drug reactions. Patients should be educated about the potential for drug eruptions and advised to report any new skin changes promptly.

Related pages

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-'''Drug eruption''', also known as '''drug rash''', refers to a variety of skin conditions that can occur as an adverse reaction to a drug. These reactions can range from mild rashes to severe and life-threatening conditions such as [[Stevens-Johnson syndrome]] and [[toxic epidermal necrolysis]]. Drug eruptions can affect individuals of any age, gender, or race and can be triggered by prescription medications, over-the-counter drugs, or herbal supplements.
+{{Short description|An adverse reaction to a medication manifesting on the skin}}
-==Causes==
+==Overview==
-Drug eruptions are caused by the body's immune response to a medication. The reaction can be immediate or delayed, with symptoms appearing hours to weeks after drug exposure. The exact mechanism varies depending on the type of drug eruption, but it generally involves the activation of the immune system by the drug or its metabolites, leading to inflammation and skin damage.
+A '''drug eruption''' is a type of [[adverse drug reaction]] that manifests as a skin condition. These eruptions can vary widely in appearance and severity, ranging from mild rashes to severe, life-threatening conditions. Drug eruptions are a common reason for dermatological consultations and can be caused by a wide variety of medications.
-==Types==
+==Pathophysiology==
-There are several types of drug eruptions, each with distinct characteristics and causes. Some of the most common include:
+Drug eruptions occur when the body's [[immune system]] reacts to a medication. This reaction can be mediated by different immunological mechanisms, including [[IgE-mediated hypersensitivity]], [[T-cell mediated reactions]], and [[immune complex]] formation. The specific mechanism often determines the type and severity of the eruption.
-* [[Exanthematous drug eruptions]]: The most common type, characterized by widespread red patches and sometimes accompanied by fever and malaise.
+==Types of Drug Eruptions==
-* [[Urticaria]] and [[angioedema]]: Hives and swelling, often appearing suddenly and sometimes as part of an allergic reaction.
-* [[Fixed drug eruption]]: A localized reaction that recurs at the same site with re-exposure to the drug.
-* [[Drug-induced hypersensitivity syndrome]]: A severe reaction that includes fever, rash, and internal organ involvement.
-* [[Photosensitivity reactions]]: Skin reactions triggered by exposure to sunlight due to increased sensitivity caused by the drug.
-==Symptoms==
+===Exanthematous Eruptions===
-Symptoms of drug eruptions vary widely but commonly include:
+Exanthematous eruptions, also known as [[maculopapular rash]]es, are the most common type of drug eruption. They typically appear as widespread red spots and bumps on the skin and are usually symmetrical. These eruptions are often benign and resolve after discontinuation of the offending drug.
-* Red, itchy rashes
+===Urticarial Eruptions===
-* Swelling
+[[Urticaria]], or hives, are raised, itchy welts on the skin that can be caused by drug reactions. These eruptions are often associated with [[IgE-mediated hypersensitivity]] and can occur rapidly after drug exposure.
-* Blisters or lesions
-* Peeling skin
+===Fixed Drug Eruptions===
-* Fever and general malaise in severe cases
+A fixed drug eruption is characterized by a well-defined, round or oval patch that recurs at the same site each time the drug is taken. These lesions can be red, purple, or brown and may blister.
+===Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis===
+[[Stevens-Johnson syndrome]] (SJS) and [[toxic epidermal necrolysis]] (TEN) are severe, life-threatening drug eruptions. They involve widespread skin detachment and mucous membrane involvement. These conditions require immediate medical attention and often hospitalization.
 ==Diagnosis==
-Diagnosis of a drug eruption involves a thorough medical history, including a list of all medications taken, and a physical examination. Skin biopsy and blood tests may be performed to rule out other conditions and confirm the diagnosis. In some cases, patch testing or drug challenge tests are used to identify the specific drug causing the reaction.
+The diagnosis of a drug eruption is primarily clinical, based on the patient's history and the appearance of the skin lesions. A detailed medication history is crucial, including over-the-counter drugs and supplements. In some cases, [[skin biopsy]] or [[patch testing]] may be used to confirm the diagnosis.
-==Treatment==
+==Management==
-The primary treatment for a drug eruption is discontinuation of the offending medication. Mild reactions may be managed with antihistamines or topical corticosteroids to relieve itching and inflammation. Severe reactions may require systemic corticosteroids or hospitalization, especially if internal organs are involved. Rechallenge with the drug is generally avoided due to the risk of a more severe reaction.
+The primary treatment for drug eruptions is the discontinuation of the offending medication. Supportive care, such as [[antihistamines]] for itching or [[corticosteroids]] for inflammation, may be provided. In severe cases, such as SJS or TEN, hospitalization and intensive care may be necessary.
 ==Prevention==
-Prevention of drug eruptions involves careful review of a patient's drug history before prescribing new medications and avoiding drugs known to cause reactions in the individual. Patients with a history of drug allergies should wear medical alert bracelets and inform healthcare providers of their allergies.
+Preventing drug eruptions involves careful prescribing practices, including reviewing patient allergies and previous drug reactions. Patients should be educated about the potential for drug eruptions and advised to report any new skin changes promptly.
-==See also==
+==Related pages==
 * [[Adverse drug reaction]]
+* [[Hypersensitivity]]
 * [[Dermatology]]
-* [[Immunology]]
+[[File:Drug_eruptions.jpg|thumb|right|A typical drug eruption rash on the skin.]]
 [[Category:Dermatology]]
-[[Category:Drug eruptions]]
 [[Category:Adverse drug reactions]]
-[[Category:Immunology]]
-{{Medicine-stub}}