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[Skin and hair]

V A Briner1

  • 1Medizinische Klinik, Kantonsspital Luzern.

Schweizerische Medizinische Wochenschrift
|April 6, 1996
PubMed
Summary
This summary is machine-generated.

Drug-induced skin reactions affect 2-5% of patients, with exanthematous reactions and urticaria being most common. Penicillin, sulfonamides, and NSAIDs are frequently implicated, highlighting the need for careful drug monitoring.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Clinical Medicine

Background:

  • Drug-induced skin effects are a significant concern, affecting 2-5% of patients on medication.
  • Cutaneous reactions, including exanthematous reactions (75%) and urticaria (30%), are common adverse drug events.

Observation:

  • The incidence of skin reactions correlates with drug quantity prescribed and consumed globally.
  • Commonly implicated drugs include penicillin, sulfonamides, and nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Reactions can be predictable (e.g., chemotherapy-induced alopecia) or unpredictable, stemming from allergic or non-allergic mechanisms.

Findings:

  • Unpredictable reactions may arise from allergic (Type I-IV) or non-allergic pathways, including enzyme deficiencies affecting drug metabolism.

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  • Specific patient populations, such as those with low acetylation rates or infectious mononucleosis, may be more susceptible.
  • In patients with Acquired Immunodeficiency Syndrome (AIDS), sulfonamides are a notable risk factor for severe reactions like toxic epidermal necrolysis.

    • Implications:

    • Prompt diagnosis of cutaneous drug reactions necessitates drug withdrawal, though continuation may be considered for mild cases with no alternatives.
    • Mild morbiliform eruptions can be precursors to severe conditions like toxic epidermal necrolysis, demanding vigilance.
    • Current diagnostic tests for non-Type 1 hypersensitivity reactions exhibit limited sensitivity and specificity.