ALLERGIC DRUG ERUPTION :

TREATMENT AND MEDICATION

Elda Oncossya P (106 105 0134)
ALLERGIC DRUG ERUPTION
General term for eruptions in the skin and
mucosa induced by a drug or its metabolites
Classification of Drug Eruptions by Pathogenesis
GOAL ?
Discontinue the offending mechanism and
allergic reactions to a certain drugs
Dx : Medical History & PE
Assessment of Drug
Reactions
Guidelines for Assessment of Possible
Adverse Drug Reactions :
Exclude alternative causes
Examine interval between drug introduction and
onset of reaction
Note any improvement after drug withdrawal
Determine whether similar reactions have been
associated with same compound
Note any different reaction on readministration of
the drug(s)
ALLERGIC DRUG ERUPTIONS :
1. Urticaria
Major drugs involved: antibiotics, (penicillins,
cephalosporins, sulfonamides, tetracyclines), NSAIDS,
contrast media
Treatment:
Self-limiting disease
Withdraw causative agent, avoid in future
Primarily treated with H1 antihistamines
2. Angioedema
Associated with urticaria in 50% of cases.
ACE inhibitor induced angioedema (onset: few minutes to
years), penicillins, NSAIDs, contrast media
Treatment:
Withdraw offending drug and avoid in future
H1 antihistamines.
If severe or breathing/swallowing difficulties, systemic
corticosteroids, subcutaneous adrenalin/epinephrine
3. Xanthematous Drug Eruption
Synonyms: Morbilliform eruption or maculopapular drug
eruption
Most common drug reactions affecting skin, start 7-14
days of starting new drug
Drugs involved: Penicillins, Carbamazepine, Allopurinol,
Sulfonamides
Treatment:
Discontinue offending agent.
Largely supportive, topical steroids
Antihistamines may alleviate pruritus.
Spesific Types of Drug-Induced Skin Reactions :
Fixed Drug Eruptions (FDE)
Eruptions that reccur at the same site each time
the same drug is administered.
(most causative drugs : NSAIDs, Tetracyclines, Sulfa, Food Additives)
Red/ purple patches
Multiple patches
D = 1cm 10cm
Itching & pain
TREATMENT
Oral Antihistamine
Causative drug should be discontinued
Sources :
1. Gruchalla Rebecca S, MD, PhD.Journal of Allergy and Clinical
Immunology : Drug metabolism, danger signals, and drug-
induced hypersensitivity. Volume 108, Issue 4. Pages 475-
488, October 2011
2. Jonathan E Blume, MD . Drug Eruption: Medication.Clinical
Dermatology, Columbia University College of Physicians and
Surgeons. 8 April 2013
3. Rasad Asri, MSc. Ilmu Penyakit Kulit dan Kelamin : Erupsi
Obat Alergik. Jakarta : FKUI. 154-158.