Erythema Multiforme and Drug Reactions
Fig. 7.1 Atypical target lesions with dusky center (typical of people of color) and surrounding erythema in a patient who flares with episodes of genital HSV Historical Perspective In 1866,…
Drug-Induced Delayed Multi-organ Hypersensitivity Syndrome
Fig. 25.1 Exanthem over legs developing a violaceous hue before scaling. This patient had been on clindamycin for many weeks and developed this skin eruption, which generalized with time. He…
Pityriasis Rosea-Like Drug Eruptions
Drug eruption-like pityriasis rosea Gilbert’s pityriasis rosea Absence of initial single herald patch Presence of initial single herald patch Bright violet-red lesions Salmon-pink lesions Pruritus unrelieved by antihistamines Pruritus relieved…
Drug-Induced Urticaria
Fig. 6.1 Symmetric urticarial drug eruption due to cephalexin over the back. This was acute and discontinuation of the drug resulted in rapid resolution Antibiotics: penicillins, cephalosporins, macrolides, aminoglycosides, tetracyclines,…
Erythema Nodosum as a Drug Eruption
Fig. 11.1 Symmetrically distributed on the anterior shins there are erythematous, warm, indurated plaques that were confirmed to be EN on histopathology Fig. 11.2 A close-up of the lesions of…
Lichen Planus Drug Reactions
Fig. 12.1 Dramatic hyperpigmentation over the back in a patient on gold therapy. The biopsy was compatible with a lichenoid drug eruption. The newer lesion on the upper back show…
Immunology of Cutaneous Drug Eruptions
Mediator Mechanism(s) Clinical phenotypes Type I Immediate IgE Ag binding to mast cell/basophil surface receptors Urticarial, anaphylaxis, angioedema Type II Antibody-mediated (cytotoxic) IgM, IgG Ab binds to Ag leading…
Principles of Diagnosis of Cutaneous Drug Eruptions
Allergic Toxic Clinical Urticaria, morbilliform, etc. Mimics action of drug Histopath Nonspecific Mimics action of drug Dose of drug Not dose-related, idiosyncratic Less dose may cure; Universal at high…
