Drug-induced eczema

Question 1

What is the definition of drug-induced eczema?

Answer 1

Systemic allergic contact dermatitis, includes baboon syndrome, elicitation of an eczematous reaction following topical sensitisation on subsequent re-exposure to the same substance

Question 2

What is the epidemiology of drug-induced eczema?

Answer 2

Rare

Question 3

What is the pathophysiology of drug-induced eczema?

Answer 3

Drug-specific T cell induced inflammation in the skin; possibility of sensitisation by other routes such as implants or prostheses

Question 4

What can happen to a patient with a contact allergy to ethylenediamine?

Answer 4

They may develop urticaria or systemic eczema following ingestion of aminophylline preparations containing ethylene diamine as a solubiliser for theophylline

Question 5

What is a potential reaction for someone with a contact allergy to parabens?

Answer 5

They may develop systemic eczema on medication which contains paraben as a preservative

Question 6

Can drug reactions occur without prior contact allergy?

Answer 6

Yes, examples include penicillin and B-lactam antibiotics

Question 7

What is SDRIFE?

Answer 7

Symmetrical sharply demarcated redness of the buttocks/perineum, groin, and one other flexural site; absence of systemic signs; delayed type T cell mediated drug hypersensitivity

Question 8

What are some causes of SDRIFE?

Answer 8

• Amoxicillin and other antibiotics (bactrim, erythromycin, clindamycin, gentamicin, ceftriaxone)
• Analgesics (panadol, NSAIDs, opiates)
• Blockers
• Clonidine, cetuximab, clobazam, corticosteroids
• Doxepin
• Ephedrine, epileptics (phenobarbital)

Question 9

What is the management for drug-induced eczema?

Answer 9

Remove drug; for severe reactions, prednisolone may be appropriate

Question 10

Fill in the blank: A patient with drug-induced eczema may experience _____ following topical sensitisation.

Answer 10

[eczematous reaction]