Hypersensitivity to drugs

In most cases hypersensitivity reaction to drugs manifests as eczema. Exanthema and urticaria are the most common types of drug eruptions. Rarer manifestations include erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome), eczematic reactions, erythroderma, i.e. exfoliative dermatitis, lichenoid, i.e. lichen Ruben's-type reactions, SLE or lupus erythematosus-type reactions, erythema nodosum and photoallergic and phototoxic reactions. Drugs can cause almost any kind of eczema and their clinical pictures can also resemble mixtures of typical skin reaction types.Sensitization to a topical drug, may cause so-called systemic contact eczema when the patient later takes the same or related drug orally. The most common causes are antibiotics (sulphonamides and penicillin in particular), NSAIDs and CNS drugs (usually phenytoin and carbamazepine First of all, the patient must stop taking the suspected drugs (preferably all drugs the patient is using). Stopping the use of the drug is usually sufficient therapy for mild exanthemas.

Urticaria reactions are treated by antihistamines.

Prolonged and severe reactions with general symptoms are treated by per oral corticosteroids.


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