Exanthematous drug eruptions. • «rashes». • Urticaria immediate reactions. • Delayed appearing exanthems with cell infiltration it is frequent. Therapy for exanthematous drug eruptions is supportive, involving the administration of oral antihistamines, topical steroids, and moisturizing. Morbilliform or exanthematous drug reaction (maculopapular drug eruption). Authoritative facts about the skin from DermNet New Zealand.

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Confluence and severity is worst in dependent areas, such as the back in hospitalized patients Figure 1. Scarlatiniform eruptions, such as Kawasaki syndrome should also be considered. Expected results of diagnostic studies The diagnosis is made based on the typical clinical appearance in concert with an appropriate drug history and the absence of systemic involvement.

Initially, there are erythematous blanching macules and papules, which may coalesce to form larger macules and plaques. Treatment Options Treatment options are summarized in Table I. Prescribers must be vigilant. The starting date of each new drug is documented together with the onset of the rash.

Type IV hypersensitivity has been subdivided into four groups, depending on whether monocytes type IVaeosinophils type IVbor neutrophils type IVd are predominantly activated or whether there is T-cell-mediated apoptosis type IVc. See the DermNet NZ bookstore. Morbilliform drug eruption usually first appears on the trunk and then spreads to the limbs and neck. Toxin-mediated erythemas, such as toxic shock syndrome and Strep toxic shock-like syndrome may present with an eruption that resembles MDE.


It is usually symmetric. Here, the rash will get worse before it ultimately gets better and resolves. Other than this, systemic involvement is not a feature.

Clinical practice. Exanthematous drug eruptions.

DermNet NZ does not provide an online consultation service. Morbilliform drug eruption is the most common form wruption drug eruption. Occasionally, duskiness may be seen in the resolving phases of MDE- here, the areas are not tender. If the causative drug is ceased, the rash begins to improve within 48 hours and clears within 1—2 weeks.

Morbilliform drug reaction

However, this is not always seen. On the first occasion, a morbilliform rash usually appears 1—2 weeks after starting the drug, but it may occur up to 1 week after stopping it. Diagnosis confirmation The following conditions should be considered in the differential diagnosis: In cases where it is not possible to do this, such as an antibiotic that is eruptiob to a drug regimen, symptomatic and supportive treatment while continuing the drug therapy is a feasible option.


Approach dug the morbilliform eruption in the hematopoietic transplant patient. The diagnosis is made based on the typical clinical appearance in concert with an appropriate drug history and the absence of systemic involvement.


The face may be involved, but mucous membranes are typically spared. Patients should be cautioned not to use strong topical steroids on the face or in the folds.

Drug eruptions — Medscape Reference Books about skin eruptoon The history of upper respiratory tract symptoms and the presence of a lymphocytosis or lymhopenia on the white blood cell differential count as opposed to an eosinophilia point one towards a viral etiology.

Clinical practice. Exanthematous drug eruptions.

Numerous other drugs have been reported to cause morbilliform drug eruptionsrxanthematous herbal and natural therapies. Topical steroids and antihistamines will be required in these erupyion. In typical cases, a biopsy is not required. Often, however, these patients have been on multiple drugs, which complicate the clinical picture.

A postinflammatory fine desquamation may also be seen. Here Th 2 cells secrete interleukins 4, 13 and 5, which call eosinophils into the infiltrate, amongst other functions. Skin pain is a feature, as opposed to itch that accompanies MDE.