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Cutaneous drug reactions.

C K Svensson¹, E W Cowen, A A Gaspari

¹Department of Pharmaceutical Sciences, Wayne State University, Detroit, MI 48202, USA. cks@wizard.pharm.wayne.edu

Pharmacological Reviews

|September 8, 2001

Summary

Cutaneous drug reactions, common adverse drug events, range from mild to life-threatening. This review categorizes these skin reactions by mechanism, highlighting key drug classes and predisposing factors like viral infections.

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Area of Science:

Dermatology
Pharmacology
Immunology

Background:

Cutaneous drug reactions are the most common adverse drug events, affecting 1-3% of hospitalized patients and potentially exceeding 10% for specific drugs.
These reactions vary in severity from mild discomfort to life-threatening conditions.
Anti-infective and anticonvulsant agents are frequently implicated in adverse skin reactions.

Purpose of the Study:

To describe the clinical morphology of common cutaneous drug reactions.
To identify drugs most frequently associated with specific reactions.
To categorize reactions based on known mechanisms and review current knowledge.

Main Methods:

Review of current literature on cutaneous drug reactions.
Categorization of reactions into immediate-type immune-mediated, delayed-type immune-mediated, photosensitivity, and autoimmune syndromes.
Assessment of drug-specific reaction types, mechanisms, and predisposing factors.

Main Results:

Cutaneous drug reactions exhibit diverse clinical presentations, even with the same agent, suggesting multiple initiation mechanisms.
Proposed categorization based on known mechanisms is recommended over varied existing terminologies.
Viral infections may predispose individuals to developing cutaneous drug reactions.

Conclusions:

Understanding the mechanisms underlying cutaneous drug reactions is crucial for accurate classification and management.
Specific drug classes, such as anti-infectives and anticonvulsants, require careful monitoring for potential skin adverse events.
Further research into the interplay between viral infections and drug-induced skin reactions is warranted.

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