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Drug Allergy and Cutaneous Adverse Reactions

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Allergic Diseases – From Basic Mechanisms to Comprehensive Management and Prevention

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 268))

Abstract

Allergy or hypersensitivity to drugs often affects the skin and sometimes also mucosa. While immediate type reactions show a rather homogeneous pattern, delayed type reactions reveal a high variability. In both cases it may not always be easy to differentiate drug reactions from non-drug-induced skin conditions. Furthermore, the different types of cutaneous adverse reactions may be difficult to distinguish in the beginning. This accounts predominately for delayed hypersensitivity reactions that can occur after a variety of medications and present with manifold lesions. Most of these cutaneous adverse reactions are mild, but some are severe with high morbidity and mortality. In the clinical setting, it is important to recognize the signs that point to a more severe condition early on in order to initiate appropriate management. In addition, it is crucial to identify the potentially culprit medication on the basis of a detailed medication history and by evaluating the relevant exposure times of certain drugs that differ substantially between the various reaction types. After the acute stage of the adverse reaction is managed successfully, further allergologic testing may be undertaken to confirm the offending drug.

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Abbreviations

AGEP:

Acute generalized exanthematous pustulosis

BSA:

Body surface area

DRESS:

Drug reaction with eosinophilia and systemic symptoms

FDE:

Fixed drug eruption

GBFDE:

Generalized bullous fixed drug eruption

ICU:

Intensive care unit

MPE:

Maculopapular exanthema

SCAR:

Severe cutaneous adverse reactions

SDRIFE:

Symmetrical drug-related intertriginous and flexural exanthema

SJS:

Stevens-Johnson syndrome

TEN:

Toxic epidermal necrolysis

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Author information

Authors and Affiliations

  1. Dokumentationszentrum schwerer Hautreaktionen (dZh), Department of Dermatology, Medical Center and Medical Faculty, University of Freiburg, Freiburg, Germany

    Maja Mockenhaupt

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  1. Maja Mockenhaupt
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Editors and Affiliations

  1. Department of Environmental Medicine, University Augsburg, Medical Faculty, Augsburg, Germany

    Claudia Traidl-Hoffmann

  2. Charité - Universitätsmedizin Berlin, Klinik für Dermatologie, Berlin, Berlin, Germany

    Torsten Zuberbier

  3. Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hanover, Germany

    Thomas Werfel

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Mockenhaupt, M. (2021). Drug Allergy and Cutaneous Adverse Reactions. In: Traidl-Hoffmann, C., Zuberbier, T., Werfel, T. (eds) Allergic Diseases – From Basic Mechanisms to Comprehensive Management and Prevention . Handbook of Experimental Pharmacology, vol 268. Springer, Cham. https://doi.org/10.1007/164_2021_490

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