Drug allergy physical examination
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]
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Overview
Physical Examination
Appearance of the Patient
This will vary depending on the severity of the reaction. Patient may be uncomfortable, itchy, or may just have a very localized area of redness. They may have a rash or lesions that are visible on first glance, and if they are experiencing bronchospasm or angioedema, they may be visibly short of breath.
Vitals
Temperature
- A fever may be present
Pulse
Rate
- Tachycardia may be present in cases that develop into anaphylactic shock.
Rhythm
- The pulse is regular
Strength
- The pulse may be weak
Blood Pressure
- Hypotension may be present in cases leading to anaphylactic shock
Respiratory Rate
- Tachypnea may be present
- Bradypnea may be present
- Kussmaul respirations may be present
Skin
- Erythema multiforme (target lesions) may be present
- Erythematous rash that blanches may be present
- Skin may be warm to the touch
- Sloughing of the skin may be present
- Blisters, pustules, and pus may be present
- Nikolsky's sign may be present (in toxic epidermal necrolysis)
- Petechiae may be present in conditions causing vasculitis
- Exanthema may be present , that appear as diffuse, fine macules and papules
- Urticaria
- Jaundice may be present in cases with liver involvement
Head
- There may be an area of localized redness in a contact dermatitis skin allergy
Eyes
- Conjunctivitis with redness and tearing of the eye may be seen
Throat
Neck
- Lymphadenopathy may be seen with drug rash with eosinophilia and systemic symptoms syndrome (DRESS)