Drug rash

A drug rash, also known as a drug eruption, is a skin reaction resulting from exposure to a medication or pharmacologic substance. These rashes can vary significantly in appearance and severity, depending on the type of drug involved and the individual's response.

Causes

Drug rashes are caused by a hypersensitivity reaction to a medication, which can occur for several reasons:

• An allergic reaction to the medication.
• Direct toxicity from the drug.
• Accumulation of the drug in the skin.
• Photosensitivity reactions, where the rash occurs on sun-exposed skin due to interaction between the drug and ultraviolet light.

Commonly implicated drugs include:

• Antibiotics, particularly penicillins and sulfa drugs.
• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Anticonvulsants.
• Diuretics.

Types

There are several types of drug eruptions, including:

• Exanthematous or maculopapular rash, the most common type.
• Urticaria (hives).
• Fixed drug eruption.
• Stevens-Johnson syndrome and toxic epidermal necrolysis, which are severe and potentially life-threatening.

Symptoms

Symptoms of a drug rash may include:

• Red or purple spots on the skin.
• Hives.
• Itching.
• Blisters or lesions in severe cases.

The rash typically appears within days to weeks after starting the offending medication.

Diagnosis

Diagnosis involves:

• A review of the patient's medical history and medications.
• Physical examination of the rash.
• In some cases, skin tests, biopsy, or blood tests may be conducted to rule out other conditions and confirm the diagnosis.

Treatment

The primary treatment for a drug rash includes:

• Discontinuing the offending drug, under medical guidance.
• Corticosteroids and antihistamines to reduce inflammation and itching.
• In severe cases, hospitalization may be required for management with intravenous medications and supportive care.

Prevention

Prevention strategies focus on:

• Careful review of a patient's drug history before prescribing medications.
• Avoiding known allergens.
• Educating patients on the potential side effects of medications.

Drug rash Resources
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