drug eruptions

•are common.
•may be fatal.

I will present

1. approach 2. FDE - EM - TEN

morphological diagnosis non-drug causes history lists elimination symptomatic therapy skin tests provocation prohibition steps of approach .

.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition maculopapular is the most common rashform.

.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition is the second most urticaria common form.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition

may continue for lichenoid months after eruption the stop of the drug.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition

this patient was acneiform lesions using acneiform cortisone occurred for post-traumatic eruption as a side effect. cerebral edema.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition

oral contraceptives erythema nodosum may be the cause.

media.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition iodide is used as iodide is present is an characterized intravenous iododerma in cough by radiocontrast vegetations. remedies. .

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition cutaneous side effects of drugs any may simulate distribution almost every any course skin diseases. any elemantary lesion .

. are also maculopapular rashes.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition measles. rubella etc.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition urticaria .

Behçet’s disease etc. . also cause erythema nodosum.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition TBC.

Behçet’s diagnosis of drug disease etc.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition non-drug causes should be excluded for the URI. TB. . also cause erythema eruption. nodosum.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition be patient ask some drugs name by name evaluate time factors .

provocation prohibition .morphological non-drug time factors history cerebral trauma should be lists phenytoin for the first time elimination evaluated rash symptomatic very skin -5 tests-4 -3 -2 -1 0 week carefully.

morphological non-drug time factors history a drug. which has not been used cerebral trauma causes an be lists before. provocation prohibition . usually should phenytoin eruption after a sensitization elimination evaluated period of several weeks.rash symptomatic very skin -5 tests-4 -3 -2 -1 0 week carefully.

morphological non-drug history pyelonephritis lists bactrim elimination symptomatic skin -5 tests-4 -3 provocation prohibition time factors should be evaluated very -2 -1 0 carefully. relapse bactrim rash week .

which has been used be lists before. rash symptomatic very skin -5 tests-4 -3 -2 -1 0 week carefully. usually should causes an bactrim bactrim elimination evaluated eruption immediately . provocation prohibition .morphological non-drug time factors history pyelonephritis relapse a drug.

morphological non-drug history lists bactrim elimination symptomatic skin -5 tests-4 -3 provocation prohibition time factors should be evaluated very -2 -1 0 carefully. aspirin rash day .

morphological non-drug time factors history if the eruption is urticaria. provocation prohibition . only should be because lists aspirin is the culprit. bactrim aspirin urticaria occurs within a day after elimination evaluated urticaria drug intake. symptomatic very skin -5 tests-4 -3 -2 -1 0 day carefully.

morphological non-drug time factors history if the eruption is maculopapular. provocation prohibition . the culprit. be lists both drugs are should bactrim aspirin because maculopapular rash may elimination evaluated maculodelay for several weeks. papular symptomatic very skin -5 tests-4 -3 -2 -1 0 day carefully.

morphological non-drug history lists captopril elimination symptomatic skin -5 tests-4 -3 provocation prohibition time factors should be evaluated very -2 -1 0 carefully. angioedema mo. .

which has been used should be safely for months even years. provocation prohibition .morphological non-drug time factors history a drug. carefully. may lists captopril also cause a cutaneous side elimination evaluated angioeffect. edema symptomatic very skin -5 tests-4 -3 -2 -1 0 mo.

morphological non-drug history lists previously ampicillin safe elimination symptomatic skin -5 tests-4 -3 provocation prohibition time factors should be evaluated very -2 -1 0 carefully. uri ampicillin rash week .

morphological non-drug time factors history ampicillin. provocation prohibition . symptomatic very skin -5 tests-4 -3 -2 -1 0 week carefully. may cause a rash in lists ampicillin safe the presence of infectious elimination evaluated rash mononucleosis. which has been used uri should be safely before.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition thousands of drugs hunderds of rash types no one remember all of them ! .

remember all of them ! thousands of drugs . which contains previous hunderds of rash types experiences. no one should be used.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition a guide.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition textbook prospectus internet .

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition treatment = cessation of drugs .

all non-vital drugs should be = stopped ! cessation of drugs morphological non-drug history lists elimination symptomatic skin tests provocation prohibition treatment .

. edema. laryngeal vitamins.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition all if angioedema drugs should even if there is an occurs be stopped in a patient evident non-drug because who is of using risk of cause of urticaria.

. that is the whole treatment”.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition do not say to a patient that “we have stopped all of your drugs.

prohibition .morphological drugs for non-drug history symptomatic relief lists should be prescribed elimination according to the symptomatic skin tests morphological provocation diagnosis.

.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition do not give an order like that “inject one ampule of cortisone”.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition precise diagnosis = rechallenge with drugs one by one .

provocation should not be rechallenge with drugs done ! one by one precise diagnosis = .morphological non-drug history lists elimination symptomatic skin tests provocation prohibition if there is risk for death.

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition indirect diagnosis prick-patch tests .

morphological non-drug history lists elimination symptomatic skin tests provocation prohibition prick test is prick test detects useful in type I allergy to a urticarial given substance. rashes. .

. rashes.morphological non-drug history lists elimination symptomatic skin tests provocation prohibition patch patch test test is detects useful type in IV allergy maculopapular to a given substance.

. erythema multiforme and toxic epidermal necrolysis will be briefly discussed in the rest of the presentation.fixed drug eruption.

fixed drug eruption main elementary lesions are round erythematous macules. .

.fixed drug eruption these erythematous macules leave hyperpigmentation.

the macules redden. .fixed drug eruption if the responsible drug is used again.

.fixed drug eruption blisters may develop on the active lesions.

.fixed drug eruption glans penis is commonly involved.

fixed drug eruption an erosion occurs after rupture. it may look like a chancre. .

syphilis. induration. palpation should be done with gloves ! an erosion occurs after rupture. .fixed drug eruption remnants of bullae indicates fixed eruption. it may look like a chancre.

erythema multiforme in the minor form macules and papules. .

erythema multiforme in the major form bullae dominate. .

erythema multiforme especially acral regions and .

erythema multiforme periorificial regions are involved: mouth. anogenital region. . eye.

erythema multiforme erythematous rings with different hues .

erythema multiforme target lesion is pathognomonic. .

.erythema multiforme target lesions are seen both in minor and major forms.

. post-herpetic EM usually has a recurrent course.erythema multiforme erythema multiforme may also be due to infections. especially herpes simplex.

erythema multiforme Stevens-Johnson syndrome bullae + mucosal lesions + fever .

.erythema multiforme there are sores in the mouth and eyes.

toxic epidermal necrolysis .

toxic epidermal necrolysis there are generalized bullae and widespread erosions. .

.toxic epidermal necrolysis it looks like staphylococcal scalded skin syndrome.

.toxic epidermal necrolysis targetoid and mucosal lesions are usually enough for differentiation.

toxic epidermal necrolysis a biopsy should be done in doubtful cases. .

toxic epidermal necrolysis it is treated like a burn. .

.toxic epidermal necrolysis unfortunately. the mortality rate is almost 50%.

if the causative is not stopped. which is the most common form of drug eruptions. may progress to toxic epidermal necrolysis.maculopapular rash. .

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