Drug dermatitis, more commonly known as a dermal drug eruption, is an adverse drug reaction that may occur on the skin, hair, and nails. The majority of drug eruptions tend to provoke mild reactions and clear once discontinuing the medication. Drugs can also cause hair and nail changes, affect the mucous membranes, or cause itching without outward skin changes. A drug-induced reaction should be considered in any patient who is taking medications and who suddenly develops a symmetric cutaneous eruption.
As stated in its name, numerous drugs can be responsible for drug dermatitis. An allergy (immunological response) to a medication is the main reason for drug dermatitis. A fixed drug eruption is the term for a drug eruption that occurs in the same skin area every time the person is exposed to the drug.
Symptoms are classified by particular clinical pathology and appearance. Following is a few examples. A bullous fixed drug eruption can be characterized by reddish or dark round macules or erythematous, edematous round plaques. Drug-induced bullous pemphigoid is more commonly found on the hands and soles and may appear as urticarial plaques may precede the tense bullae and tends to be pruritic. Drug-induced linear IgA disease appears as subepidermal blister formation with a neutrophil-predominant inflammatory infiltrate. Lesions favor trunk and extremities and palms, soles and mucous membranes may be involved. Drug-induced pemphigus may present as small; flaccid bullae eventuate into scaly or exfoliative plaques.
We may begin by collecting your chief complaint with an emphasis on how severe and persistent an eruption as well as collect any relevant medical history. While drug dermatitis is often asymptomatic, we may order further testing for extreme cases. Tests may include but not limited to biopsy, patch test, culture test, blood tests, serum tests, as well as chest imaging (for vasculitis).
A specific treatment plan will be created for you based on the offending medication and subsequent symptoms. Some treatment plans may include but not limited to oral antihistamines, topical steroids, intravenous immunoglobulin (IVIG), and moisturizing lotions. It is worth mentioning that a full recovery without any complications is expected for most drug eruptions.