Severe cutaneous adverse reactions

author 1, author 2 January 01, 2025 #hypersensitivity #drugs

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AGEP

Common culprits: penicillins cephalosporins Latency: day to few days

DRESS

Morbiliform rash, typically diffuse and confluent may have facial involvement with purpura systemic symptoms (ie fever, malaise)

BW: classically eosinophilia (>700/ul) in 50-90% (not fully sensitive); atypical lymphocytes; transaminits > renal failure

latency: 2-8 weeks post exposure takes 6-9 weeks to recover

Culprit drugs: anything but classically AEDs and allopurinol HLA associations with certain drugs: HLA-A*31 with carbamazepine, HLA-B*58 and allopurinol

Management is to STOP, but may require steroids or more specialized treatments

SJS/TENS