Cutaneous reactions
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Clinical features
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Implicated medications
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Exanthems
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▸ Delayed-type hypersensitivity ▸ Evolve over days after drug initiation ▸ Diffuse macules and papules
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Allopurinol, Amlodipine, Amphotericin, Barbiturates, Captopril, carbamazepine, cephalosporins, chloramphenicol, Digoxin, Erythromycin, Furosemide, gentamicin, Glipizide, gold salts, Lithium, Nalidixic acid, Nitrofurantoin, Penicillins, Phenothiazines, Phenylbutazone, Phenytoin, Sulfonamides, Thiazides
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Urticaria/ angioedema
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▸ Often IgE mediated ▸ Onset within minutes of drug initiation
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Abatacept, ACE inhibitors, Acetylcysteine, Acyclovir, Adalimumab, Albuterol, Alendronate, Aliskiren, Alteplase, Aminosalicylic acid, Amlodipine, Amlodipine and Benazepril, Anastrozole, Anti-inhibitor coagulant complex, Anticonvulsants, Antihemophilic factor, Antithrombin III, Aripiprazole, Armodafinil, Aspirin, Atomoxetine, Atropine, Beclometasone dipropionate, Benazepril, Budesonide And Formoterol Fumarate Dihydrate, Butabarbital, Captopril, Carbidopa and Levodopa, Carvedilol, Celecoxib, cephalosporins, Cetuximab, Cholestyramine, Ciclosporin, Cisplatin, Clomifene, Clonidine, Clopidogrel, Colestipol, Cyclobenzaprine, Darbepoetin Alfa, Darifenacin, Darunavir, Dasatinib, Deferasirox, Denosumab, desvenlafaxine, Dexamethasone, Dexlansoprazole, Dexmethylphenidate, Dextran, Diflunisal, Digoxin immune fab, Dofetilide, Donepezil, Dutasteride, Dutasteride and Tamsulosin hydrochloride, Enalapril maleate, Enoxaparin, Epoetin alfa, Erythropoietin, Esomeprazole, Eszopiclone, Everolimus, Exenatide, Ezetimibe, Factor IX complex, Febuxostat, Felodipine, Fesoterodine, Filgrastim, Fluoxetine, Fluphenazine, Fluticasone, Fosinopril, Frovatriptan, Gemfibrozil, Gentamicin, Glimepiride, Glipizide, Glyburide, Heparin, Hydralazine, Hydroxychloroquine, Hyoscyamine, Ibuprofen, Indomethacin, Interferon beta-1a, Ipratropium bromide, Ipratropium Bromide And Albuterol, Irbesartan, Isotretinoin, Isradipine, Lamotrigine, Levalbuterol, Levonorgestrel and Ethinyl estradiol, Levothyroxine, Linagliptin, Linagliptin and Metformin hydrochloride, Liraglutide, Lisinopril, Lisinopril and Hydrochlorothiazide, Loperamide, Losartan and Hydrochlorothiazide, Medroxyprogesterone, Minocycline hydrochloride, Moxifloxacin ophthalmic, Mupirocin, Losartan, Meloxicam, Metaxalone, Methimazole, Methocarbamol, Methylphenidate, Metoclopramide, Metolazone, Mirabegron, Modafinil, Moexipril hydrochloride, Monoclonal antibodies, Moxifloxacin, Nabumetone, Nafarelin, Naltrexone, Naproxen and esomeprazole magnesium, Nisoldipine, Nitrofurantoin, Norgestimate and Ethinyl estradiol, NSAIDs, Ofloxacin, Olodaterol, Olmesartan, Omalizumab, Opioids, Orphenadrine, Oxcarbazepine, Oxycodone, Pantoprazole, Pegfilgrastim, Penicillins, Pentamidine Isethionate, Pentoxifylline, Perindopril, Phentermine, Pramipexole, Prochlorperazine, Promethazine, Rifaximin, Saxagliptin, Saxagliptin hydrochloride and Metformin hydrochloride, Sertraline, Pitavastatin, Procainamide, Rizatriptan, Quinidine sulfate, Quinine, Ramipril, Ranolazine, Raxibacumab, Repaglinide, Risedronate, Rosuvastatin, Sitagliptin, Sulfonamides, Sumatriptan, Tenofovir, Tetracyclines, Thalidomide, Thiouracil, Ticlopidine, Tizanidine, Tocilizumab, Tolterodine, Tubocurarine, Ustekinumab, Valacyclovir, Valsartan, Vancomycin, Vardenafil, Varenicline, Velaglucerase alfa, Zaleplon, Zolmitriptan, Zolpidem
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Fixed drug eruption
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▸ Hyperpigmented plaques that recur at same skin or mucosal site
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ACE inhibitors, adalimumab, allopurinol, amlodipine, aspirin, barbiturates, benzodiazepines, carbamazepine, cephalosporins, clindamycin, co-trimoxazole, dextromethorphan, diltiazem, fluconazole, lamotrigine, lansoprazole, metronidazole, NSAIDs, paclitaxel, paracetamol, penicillin, phenolphthalein, omeprazole, quinine, salicylates, sulfonamides, terbinafine, tetracyclines, trimethoprim
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Pustules
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▸ Acute generalized eczematous pustulosis or acneiform rash
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antibiotics, calcium-channel blockers, corticosteroids, sirolimus,Fluticasone,Erlotinib
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Bullous
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▸ Flaccid or tense blisters
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Argatroban, Bendamustine, Captopril, Carbidopa and Levodopa, Dasatinib, Erlotinib, Penicillamine, Furosemide, Risedronate, Vancomycin,Abciximab,Warfarin, Topiramate,Linezolid,Mirtazapine,Dapsone, Allopurinol,Captopril ,Captopril and Hydrochlorothiazide,Clopidogrel,Erlotinib,Fosinopril, Ibuprofen, Imatinib,Indapamide,Risedronate,Zolpidem,Dasatinib,Minoxidil,Labetalol,Phenytoin,Dalteparin,Bendamustine,Tinzaparin,Tamoxifen,clarithromycin,Atorvastatin calcium,Caduet,Ticarcillin/Clavulanate,Terbinafine,Quinine,Nevirapine,Topiramate,Perindopril,Moexipril/Hydrochlorothiazide, Naproxen sodium
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Cutaneous lupus erythematosus
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▸ Erythematous/scaly plaques in photodistribution
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Hydrochlorothiazide, calcium-channel blockers, ACEIs
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Stevens-Johnson syndrome (SJS)
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▸ Purpuric macules on face and trunk with <10% epidermal detachment, fever, stomatitis, ocular involvement
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Antibiotics, Acetazolamide, Acyclovir, Alendronate, Armodafinil, Atazanavir, Barbiturates, Bendamustine, Β-lactam antibiotics, Brinzolamide, Carbamazepine, Carvedilol, Celecoxib, Chlorpropamide, Co-trimoxazole, Darunavir, Delavirdine, Deferasirox, Diflunisal, Dorzolamide, Duloxetine, efavirenz, emtricitabine, and tenofovir disoproxil fumarate, Erlotinib, Escitalopram, Etodolac, Fenofibrate, Glimepiride, Gold, H2 Antagonists, Histamine, Hydroxychloroquine, Indapamide, Indomethacin, Isotretinoin, Ketorolac tromethamine, Lamotrigine, Leflunomide, levetiracetam,Lisinopril and Hydrochlorothiazide, Macrolides, Mefenamic acid, Meloxicam, Metolazone, Mefloquine, Methotrexate, Mexiletine, Minocycline hydrochloride, Minoxidil, Mirabegron, Modafinil, Naproxen and esomeprazole magnesium, Piroxicam, Moxifloxacin, Nitrofurantoin, NSAIDS, Ofloxacin, Olmesartan medoxomil-Hydrochlorothiazide, Oxcarbazepine, Phenothiazines, Phenytoin, Rifampicin, Rivaroxaban, Simvastatin, Sitagliptin, Spironolactone, sulfacetamide sodium and prednisolone acetate, Sulfonamides, Tadalafil, Tetracyclines, Thalidomide, Thiazides, Ticlopidine, Varenicline, Zidovudine
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Toxic epidermal necrolysis (TEN)
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▸ Similar to SJS but >30% epidermal detachment
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Acetazolamide, Acyclovir, Alendronate, Allopurinol, Armodafinil, Atazanavir, Barbiturates, Bendamustine, Brinzolamide, Carbamazepine, Celecoxib, Delavirdine, Diflunisal, Dorzolamide, Erlotinib, Escitalopram, Etodolac, Finasteride, Gold, Griseofulvin, Indapamide, Indomethacin, Isotretinoin, Ketorolac tromethamine, Lamotrigine, Leflunomide, levetiracetam, Lisinopril and Hydrochlorothiazide, Mefenamic acid, Meloxicam, Methotrexate, Metolazone, Minocycline hydrochloride, Modafinil, Moxifloxacin, Naproxen and esomeprazole magnesium, Nitrofurantoin, NSAIDs, Ofloxacin, Olmesartan Medoxomil-Hydrochlorothiazide, Oxcarbazepine, Penicillins, Phenytoin, Piroxicam, Salicylates, Sitagliptin, Spironolactone, Sulfacetamide sodium And Prednisolone acetate, sulfonamides, tetracyclines, Thalidomide
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