Sandbox 09232014: Difference between revisions

Revision as of 18:18, 23 September 2014

Cutaneous Reactions	Clnical Features	Implicated Medications
Exanthems	Delayed-type hypersensitivity Evolve over days after drug initiation Diffuse macules and papules	Aminopenicillins, antibacterial sulfonamides, cephalosporins, allopurinol, antiepileptic agents
Urticaria/ angioedema	Often IgE mediated Onset within minutes of drug initiation	β-lactam antibiotics, ACE-Is
Fixed drug eruption	Hyperpigmented plaques that recur at same skin or mucosal site	NSAIDs, tetracyline, carbamezapine
Pustules	Acute generalized eczematous pustulosis (AGEP) Acneiform	AGEP: antibiotics, calcium-channel blockers Acneiform: corticosteroids, sirolimus
Bullous	Flaccid blisters Tense blisters	Captopril, penicillamine Furosemide, vancomycin
Stevens-Johnson Syndrome (SJS)	Purpuric macules on face and trunk with <10% epidermal detachment, fever, stomatitis, ocular involvement,	Antibacterial sulfonamides, oxicam NSAIDs, anticonvulsants, allopurinol
Toxic Epidermal Necrolysis (TEN)	Similar to SJS but >30% epidermal detachment Mortality up to 50%	Same as SJS
Cutaneous lupus	Erythematous/scaly plaques in photodistribution	Hydrochlorothiazide, calcium-channel blockers, ACE-Is

Extracutaneous Reactions	Clnical Features	Implicated Medications
Hematologic	Hemolytic anemia, thrombocytopenia, granulocytopenia	Penicillin, quinine, sulfonamides
Hepatic	Hepatitis, cholestatic jaundice	Para-aminosalacylic acid, sulfonamides, phenothiazines
Pulmonary	Pneumonitis, fibrosis	Nitrofurantoin, bleomycin, methotrexate
Renal	Interstitial nephritis, membranous glomerulonephritis	Penicillin, sulfonamides, gold, penicillamine, allopurinol

Multiorgan Reactions	Clnical Features	Implicated Medications
Anaphylaxis	Urticaria, angioedema, bronchospasm, gastrointestinal symptoms, hypotension IgE- and non–IgE-dependent reactions	β-lactam antibiotics, mAbs
DRESS	Cutaneous eruption, fever, eosinophilia, hepatic dysfunction, lymphadenopathy	Anticonvulsants, sulfonamides, minocycline, allopurinol
Serum Sickness	Arthralgias, myalgias, fever, malaise	Hydralazine, procainamide, isoniazid
Vasculitis	Cutaneous or visceral vasculitis	Hydralazine, penicillamine, propylthiouracil

↑ Khan, David A. (2010-02). "Drug allergy". The Journal of Allergy and Clinical Immunology. 125 (2 Suppl 2): –126-137. doi:10.1016/j.jaci.2009.10.028. ISSN 1097-6825. PMID 20176256. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)

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 | style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Stevens-Johnson Syndrome (SJS)
-| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Fever, erosive stomatitis, ocular involvement, purpuric macules on face and trunk with &lt;10% epidermal detachment
+| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Purpuric macules on face and trunk with &lt;10% epidermal detachment, fever, stomatitis, ocular involvement,
-| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Antibacterial sulfonamides, anticonvulsants, oxicam NSAIDs, and allopurinol
+| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Antibacterial sulfonamides, oxicam NSAIDs, anticonvulsants, allopurinol
 |-
-| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | TEN
+| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Toxic Epidermal Necrolysis (TEN)
-| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Similar features as SJS but >30% epidermal detachment <BR> Mortality as high as 50%
+| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Similar to SJS but >30% epidermal detachment <BR> Mortality up to 50%
 | style="background: #F5F5F5; padding: 5px 5px;" valign=top | Same as SJS
 |-