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Published on: October 3, 2019
Pediatric drug eruptions
EmilyD Nguyen1, Colleen K Gabel2, JiaDe Yu3
1Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA; Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Insights
Pediatric drug eruptions are common and impact children
Area of Science:
- Pediatric Dermatology
- Pharmacovigilance
- Clinical Toxicology
Background:
- Drug eruptions are frequent in children, impacting health and future treatment options.
- Understanding pediatric drug reactions is crucial for accurate diagnosis and management.
- Mechanisms and differences between pediatric and adult drug reactions are poorly understood.
Purpose of the Study:
- To review common pediatric drug eruption patterns.
- To discuss diagnostic mimics and management strategies for pediatric drug reactions.
- To highlight key features of five specific cutaneous adverse drug reactions in children.
Main Methods:
- Literature review focusing on pediatric drug eruptions.
- Analysis of clinical features, diagnostic workup, and management.
- Presentation of five common cutaneous adverse drug reactions.
Main Results:
- Common pediatric drug eruption patterns include morbilliform, urticarial, serum sickness-like reactions, fixed drug eruptions, and DRESS syndrome.
- Diagnostic challenges and mimics are discussed.
- Management strategies are emphasized for the pediatric population.
Conclusions:
- Accurate diagnosis and management of pediatric drug eruptions are essential.
- Further research is needed to understand mechanistic differences between children and adults.
- Standardized treatment protocols for pediatric drug reactions are lacking.
Abstract:
Drug eruptions in children are common but in general less studied than their adult counterparts. Aside from having significant impact on the child's health and quality of life, these reactions can limit what medications the patient can receive in the future. Familiarity with pediatric drug eruptions is important for accurate diagnosis and to prevent future recurrence or ineffective therapy. Our current understanding of how drug reactions differ mechanistically between children and adults is poor. There are multiple factors that could be contributing to the differing incidence, presentation, and treatment modalities offered to pediatric versus adult patients. For many of these cutaneous drug reactions, the treatment regime is not standardized, being based primarily on case reports. Although not comprehensive, this review highlights common pediatric drug eruption patterns and discuss diagnostic mimickers. Five cutaneous adverse drug reactions in the pediatric population are presented: morbilliform (exanthematous) eruptions, urticarial eruptions, serum sickness-like reactions, fixed drug eruptions, and DRESS syndrome. Clinical features, diagnostic workup, and management are discussed with an emphasis on the pediatric population.
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