Drug eruptions are common problems in hospital inpatients and outpatients. Cutaneous drug reactions range from mild to severe and from those localized only to skin to those associated with systemic disease. Cutaneous drug reactions are also a challenging diagnostic problem since they can mimic a large variety of skin diseases, including viral exanthem, collagen vascular disease, neoplasia, bacterial infection, psoriasis, and autoimmune blistering disease, among others. Furthermore, determining a particular medication which caused an eruption is often difficult when the patient is taking multiple drugs. In this review, clinical manifestations of adverse cutaneous drug reactions are described. A morphologic approach to drug eruption includes those that are classified as exanthematous eruption, urticaria, pustular eruption, bullous eruption, fixed drug eruption, photosensitive eruption, skin necrosis, lichenoid eruption, cutaneous pseudolymphoma, lupus erythematosus, and hand-foot syndrome. And also, recently reported cutaneous adverse reactions associated with newly developed drugs, such as epidermal growth factor receptor inhibitors, low molecular weight tyrosine kinase inhibitors, tumor necrosis factor-alpha antagonists, sirolimus and granulocyte colony-stimulating factor, are discussed.
Citations
, Moon-Jung Kim, Soyun Cho, Kyu-Kwang Whang, Jeong-Hee Hahm This study attempts to evaluate the clinical manifestations and causative drugs of drug eruptions at Ewha Womans University Tongdaemun Hospital by retrospective study of outpatients, inpatients and consulted patients(number : 121, duration : 1994. 1 - 1999. 5).
1) Most drug eruptions occurred in patients at the age of 20 - 39 years old.
2) The cutaneous manifestations of drug eruptions in the order of frequency were as follows : exanthematous eruption, fixed drug eruption, acneiform eruption, purpura, urticaria, bullous eruption, lichenoid eruption, Stevens-Johnson syndrome, and acute generalized exanthemic pustulosis.
3) Drug eruption developed most frequently from 24 hours to 3 days of drug intake.
4) Most common causative drugs were antibiotics, followed by antipyretics and analgesics.
5) Laboratory abnormalities were leukocytosis(22.5%), eosinophilia(14.5%), abnormal AST/ALT(11.4%), abnormal IgE titer(8.3%), and leukopenia(5.6%).
The most frequent clinical feature of the drug eruption were exanthematous in nature and the most common causative drugs were antibiotics, as suspected.
Since too many patients take various unidentified drugs at drug stores in Korea, physicians need to exercise special care in prescribing drugs and evaluating patients with drug eruption.
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