Adverse Cutaneous Drug Reaction

Abstract

Drug-induced skin disease or cutaneous adverse drug reaction (CADR) is a term encompassing clinical manifestations of the skin, induced by drugs or their metabolites. The skin is the organ most commonly affected by drug reactions, affecting up to 10% of hospitalized patients and can occur in 1–3% of her polypharmacy patients. Most CADRs are mild or self-resolving conditions. The most frequently reported are macular papular rash, urticaria/angioedema, fixed drug eruption and erythema multiforme. Less common but more severe patterns include, drug reactions with eosinophilia and systemic symptoms, and the Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum. Almost any drug can induce CADR, but antibiotics (especially sulfa drugs), nonsteroidal anti-inflammatory drugs, and antiepileptic drugs are most commonly implicated. Various mechanisms are involved in the pathogenesis of CADR, some of which are still unknown. Which may be immune mediated or non-immune mediated Recognition of a specific CADR depends primarily on the physician's ability to perform a detailed clinical examination, an accurate description of the skin lesion morphology, and corroboration of laboratory and/or skin biopsy findings.