Drug-Induced Exanthems
Characteristics
- Account for close to 75% of all drug eruptions.
-
Morbilliform, maculopapular eruptions.
-
Most commonly implicated medications are the most commonly prescribed medications (antibiotics, sulfa).
-
Often associated with pruritis, low-grade fever, eosinophilia.
-
May be the early stage of more severe reactions such as toxic epidermal necrolysis, DRESS
-
Onset within 2 weeks of starting a new drug, or within days of re-exposure.
-
Delayed (type IV) hypersensitivity is most likely etiology.
-
Treatment is dicontinuation of the drug. Antihistamines, topical steroids, and topical antipruritics may also help.
Morbilliform eruption
Drug-induced exanthems, such as this morbilliform eruption, often begin in dependent areas and generalize. A morbilliform eruption can be the presenting sign of a more serious reaction such as toxic epidermal necrolysis, hypersensitivity syndrome, or serum sickness. Courtesy of Andrew Samel, MD.
