Cutaneous Drug Eruptions

Question 1

What is a cutaneous drug eruption

Answer 1

Adverse drug reaction of the skin

Question 2

Give some examples of non immunological reactions

Answer 2

Eczema
Drug-induced alopecia
Photo-toxicity
Psoriasis
Pigmentation

Question 3

Who is most likely to get a cutaneous drug eruption

Answer 3

Young female adults

Question 4

Name some patient risk factors for drug eruptions

Answer 4

Genetic influence, concomitant disease, immune status

Question 5

Name some concomitant diseases linked to drug eruptions

Answer 5

Viral infections: HIV, EBV, CMV
cystic fibrosis

Question 6

Drug risk factors for a drug eruption

Answer 6

Chemistry, topical route, higher dose/longer half life

Question 7

Give some examples of drug chemistry that are a risk for a drug eruption

Answer 7

B-lactam compounds, NSAIDs, high molecular weight

Question 8

What is the most common type of drug reaction

Answer 8

Exanthematous

Question 9

What type of allergic reaction is an exanthematous drug eruption

Answer 9

Type 4

Question 10

What drugs are commonly associated with exanthematous drug reactions

Answer 10

Antibiotics, anti-epileptics, allopurinol, NSAIDs, chloramphenicol

Question 11

When does an exanthematous drug eruption usually present

Answer 11

4-21 days after first taking the drug

Question 12

Clinical presentation of an exanthematous drug reaction

Answer 12

Widespread, symmetrically distributed rash
Pruritus and mild fever are common

Question 13

What kind of allergic reaction is a urticarial drug reaction

Answer 13

Type 1 hypersensitivity

Question 14

When does a urticarial reaction usually occur

Answer 14

After rechallenge with a drug

Question 15

What is another cause of a urticarial reaction

Answer 15

A direct release of inflammatory mediators from mast cells on first exposure

Question 16

What is an acneiform drug reaction

Answer 16

Skin condition that looks like acne vulgaris but is induced by medications

Question 17

Give some examples of drugs that can cause an acneiform drug eruptions

Answer 17

Glucocorticoids
Androgens
Lithium
Isoniazid
Phenytoin

Question 18

Name some drugs that can cause AGEP

Answer 18

Antibiotics
CCBs
Anti-malarials

Question 19

What is AGEP

Answer 19

Acute generalised exanthematous pustulosis

Question 20

What causes drug-induced bullous pemphigoid

Answer 20

ACEi
Penicillin
Furosemide

Question 21

What is a fixed drug eruption

Answer 21

Well demarcated, round plaques which recur at the same site a drug is taken and resolves with persistent pigmentation when you stop the drug

Question 22

Where do fixed drug eruptions usually occur

Answer 22

Hands, genitalia, lips and occasionally the oral mucosa

Question 23

How do fixed drug eruptions present

Answer 23

Eczematous lesions, papules, vesicles or urticaria

Question 24

Name some drugs associated with fixed drug eruptions

Answer 24

Tetracycline
Doxycycline
Paracetamol
NSAIDs
Carbamazepine

Question 25

What is DRESS

Answer 25

Drug reaction with eosinophilia and systemic symptoms

Question 26

How does DRESS present

Answer 26

Widespread erythema, facial oedema, fever, lymphadenopathy and hepatosplenomegaly

Question 27

When does DRESS usually present

Answer 27

2-6 weeks after initial exposure

Question 28

Name some drugs associated with phototoxicity

Answer 28

Chlorpromazine
Quinine
Amiodarone
Doxycycline

Question 29

Management of cutaneous drug reactions

Answer 29

Discontinue drug !!!
Topical corticosteroids
Antihistamines to help with itch