Systemic drug rashes: pitfalls in diagnosis and treatment

Some of the unusual findings in eruptions from systemically administered drugs are localization to areas of trauma and localization in the mucosae. Systemic drug eruptions must be distinguished from autosensitization eczema, lesions produced by scratching, by application of drying preparations and from all the other causes of sudden widespread erythema. A calendar of the dates on which all the drugs were given is suggested to help find the causative drugs. In general, almost all drugs should be stopped and a period of time should be allowed to pass before a decision is made as to whether or not a particular drug can be implicated. Rarely, coricosteriods will have to be given. Consultation with physicians who have day-to-day experience in handling systemic drug reactions should be obtained if you are not sure of the diagnosis or management.