Severe rash associated with dexmedetomidine use during mechanical ventilation

Area of Science:

• Critical Care Medicine
• Pharmacology
• Dermatology

Background:

• Dexmedetomidine is an alpha(2)-receptor agonist used for sedation during mechanical ventilation.
• Common adverse reactions include hypotension, hypertension, nausea, bradycardia, and dry mouth.
• Dermatologic allergic reactions have not been previously reported.

Observation:

• A 22-year-old male developed a widespread wheal-and-flare rash within 4 hours of initiating dexmedetomidine infusion.
• The rash covered 60% of his body surface area and resolved within 48 hours of discontinuing the drug.

Findings:

• The Naranjo scale indicated a probable link between dexmedetomidine and the observed dermatologic reaction.
• This case suggests dexmedetomidine may cause allergic cutaneous adverse events.

Implications:

• Clinicians should consider dexmedetomidine as a potential cause of allergic skin reactions in critically ill patients.
• Close dermatologic monitoring is warranted for individuals receiving dexmedetomidine infusions.