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Eczematous Drug Eruptions.

Amy E Blum1, Susan Burgin2,3

  • 1Harvard Medical School, Boston, MA, USA.

American Journal of Clinical Dermatology
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Summary
This summary is machine-generated.

Eczematous drug eruptions, resembling eczema, are increasingly linked to new therapies like biologics and cancer treatments. Diagnosis involves drug rechallenge, with emollients and corticosteroids as effective treatments.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Immunology

Background:

  • Eczematous drug eruptions present clinically and histologically like eczema.
  • These reactions are triggered by systemically administered medications.
  • Understanding the etiology is crucial for diagnosis and management.

Purpose of the Study:

  • To review and catalog systemic medications causing eczematous drug eruptions.
  • To identify the characteristic clinical presentations of these eruptions.
  • To explore the underlying pathophysiologic mechanisms and emerging causes.

Main Methods:

  • Comprehensive literature review of eczematous drug eruptions.
  • Cataloging of causative medications and their clinical presentations.
  • Analysis of pathophysiologic etiologies, including immunomodulation, dehydration, and hypersensitivity.

Main Results:

  • Three primary pathophysiologic etiologies identified: cutaneous immunomodulation, skin dehydration, and delayed hypersensitivity.
  • Increasing incidence noted with biologic therapies (TNF-α, IL-17 inhibitors) and targeted cancer treatments (ICIs, EGFR inhibitors).
  • Other causes include antivirals (HCV) and cardiovascular drugs in the elderly; subtypes include systemic contact dermatitis and photoallergic reactions.

Conclusions:

  • Eczematous drug eruptions are diverse, with rising prevalence due to novel therapeutics.
  • Drug rechallenge is the diagnostic gold standard.
  • Treatment typically involves emollients, topical corticosteroids, and oral antihistamines.