Cutaneous Drug Reactions: Identification and Management Strategies
Cutaneous adverse drug reactions (CADR), also known as toxidermia, are skin manifestations resulting from systemic drug administration. These reactions range from mild erythematous skin lesions to much more severe reactions such as Lyell's syndrome. They represent a heterogeneous field, including various clinical patterns without specific features suggesting drug causality. This activity describes the evaluation and management of cutaneous adverse drug reactions and explains the role of the interprofessional team in managing patients with this condition. Most systemic drugs are potential causes of cutaneous adverse reactions. Contrast media and certain drug classes are known to be common offenders, such as antibiotics, anticonvulsants, antineoplastic drugs, nonsteroidal anti-inflammatory drugs, and allopurinol. Antibiotics and anti-epileptics develop toxidermia complications in 1% to 5% of treatments. There are multiple mechanisms that account for the variability in drug reactions. They can be classified into two general categories immunologic and nonimmunologic.