Abstract
Exanthematous (also known as morbilliform) drug reactions are one of the most common cutaneous adverse drug reactions (CADRs). Clinically, exanthematous reactions appear as erythematous macules and papules, sometimes accompanied by pruritus and low-grade fever, appearing days to weeks after culprit drug administration. While the pathogenesis of exanthematous drug reactions remains to be fully elucidated, it is thought to be a form of delayed T-cell hypersensitivity reaction. The list of offending agents is broad, and almost any medication may cause an exanthematous drug eruption. However, antibiotics are common offending agents. Diagnosis is clinical; identifying warning signs and symptoms of a more severe cutaneous adverse reaction is critical. Treatment of exanthematous drug eruptions is primarily supportive, providing symptomatic relief if symptoms are present. Further study is indicated for learning more about the pathophysiological mechanisms, role of systemic therapy, and role of desensitization for future use of the causative medications.
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Abbreviations
- AGEP:
-
Acute generalized exanthematous pustulosis
- BUN:
-
Blood urea nitrogen
- CADR:
-
Cutaneous adverse drug reaction
- CBC:
-
Complete blood count
- DIHS:
-
Drug-induced hypersensitivity syndrome
- DRESS:
-
Drug reaction with eosinophilia and systemic symptoms
- EBV:
-
Epstein–Barr virus
- FDE:
-
Fixed drug eruption
- HIV:
-
Human immunodeficiency virus
- HLA:
-
Human leukocyte antigen
- IHC:
-
Immunohistochemistry
- IL:
-
Interleukin
- MHC:
-
Major histocompatibility complex
- NSAIDs:
-
Nonsteroidal anti-inflammatory drugs
- p–i:
-
Pharmacologic interaction of drugs with immune receptors
- SCAR:
-
Severe cutaneous adverse reaction
- SDRIFE:
-
Symmetrical drug-related intertriginous and flexural exanthem
- SJS:
-
Stevens–Johnson syndrome
- SLE:
-
Systemic lupus erythematosus
- TEN:
-
Toxic epidermal necrolysis
- TMP-SMX:
-
Trimethoprim–sulfamethoxazole
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Gabel, C., Kroshinsky, D. (2022). Exanthematous Drug Eruptions. In: Lee, H.Y., Creamer, D. (eds) Drug Eruptions. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-031-09388-3_7
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