A drug eruption is an adverse drug reaction of the skin. Most drug-induced cutaneous reactions are mild and disappear when the offending drug is withdrawn. Drugs can also cause hair and nail changes, affect the mucous membranes, or cause itching without outward skin changes
Although most drug eruptions are exanthematous, different types of drug eruptions are described ...
diagnosed mainly from the medical history and clinical examination. However, they can mimic a wide range of other conditions, thus delaying diagnosis (for example, in drug-induced lupus erythematosus, or the acne-like rash caused by erlotinib). A skin biopsy, blood tests or immunological tests can also be useful. If the causative agent can not be withdrawn, the symptoms should be relieved as much as possible.
Although most drug eruptions are exanthematous, different types of drug eruptions are described ...
diagnosed mainly from the medical history and clinical examination. However, they can mimic a wide range of other conditions, thus delaying diagnosis (for example, in drug-induced lupus erythematosus, or the acne-like rash caused by erlotinib). A skin biopsy, blood tests or immunological tests can also be useful. If the causative agent can not be withdrawn, the symptoms should be relieved as much as possible.
Rates of reactions to commonly used drugs are as follows:
- Amoxicillin - 5.1%
- Trimethoprim sulfamethoxazole - 4.7%
- Ampicillin - 4.2%
- Semisynthetic penicillin - 2.9%
- Blood (whole human) - 2.8%
- Penicillin G - 1.6%
- Cephalosporins - 1.3%
- Quinidine - 1.2%
- Gentamicin sulfate - 1%
- Packed red blood cells - 0.8%
- Mercurial diuretics - 0.9%
- Heparin - 0.7%
Cutaneous reaction rates in patients with HIV infection are as follows :
- Sulfasalazine - 20%
- Trimethoprim-sulfamethoxazole - 14.9%
- Dapsone - 3.1%
- Aminopenicillins - 9.3%
- Penicillins - 3.8%
- Anticonvulsants - 3.4%
- Penicillinase-resistant penicillins - 2.9%
- Cephalosporins - 2.7%
- Quinolones - 2.1%
- Ketoconazole - 2%
- Clindamycin - 1.8%
- Primaquine - 1.8%
- Tetracycline - 1.2%
- Pentamidine - 1%
- NSAIDs - 0.9%
- Erythromycin - 0.6%
- Zidovudine - 0.3%
Drugs that commonly cause serious reactions are as follows:
- Allopurinol
- Anticonvulsants
- NSAIDs
- Sulfa drugs
- Bumetanide
- Captopril
- Furosemide
- Penicillamine
- Piroxicam
- Thiazide diuretics
Drugs unlikely to cause skin reactions are as follows:
- Digoxin
- Meperidine
- Acetaminophen
- Diphenhydramine hydrochloride
- Aspirin
- Aminophylline
- Prochlorperazine
- Ferrous sulfate
- Prednisone
- Codeine
- Tetracycline
- Morphine
- Regular insulin
- Warfarin
- Folic acid
- Methyldopa
- Chlorpromazine
- Serotonin-specific reuptake inhibitors
- Topical gels (eg, 4% tetracaine gel may cause serious cutaneous adverse reactions)
source : emedicine , wikipedia
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