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Cutaneous reactions Clnical features Implicated medications
Exanthems Delayed-type hypersensitivity
Evolve over days after drug initiation
Diffuse macules and papules
Aminopenicillins, antibacterial sulfonamides, cephalosporins, allopurinol, anticonvulsants
Urticaria/ angioedema Often IgE mediated
Onset within minutes of drug initiation
β-lactam antibiotics, ACEIs
Fixed drug eruption Hyperpigmented plaques that recur at same skin or mucosal site NSAIDs, tetracycline, carbamazepine
Pustules Acute generalized eczematous pustulosis (AGEP)
Acneiform
AGEP: antibiotics, calcium-channel blockers
Acneiform: corticosteroids, sirolimus
Bullous Flaccid blisters
Tense blisters
Flaccid blisters: captopril, penicillamine
Tense blisters: furosemide, vancomycin
Cutaneous lupus erythematosus Erythematous/scaly plaques in photodistribution Hydrochlorothiazide, calcium-channel blockers, ACEIs
Stevens-Johnson syndrome (SJS) Purpuric macules on face and trunk with <10% epidermal detachment, fever, stomatitis, ocular involvement Antibacterial sulfonamides, oxicam NSAIDs, anticonvulsants, allopurinol
Toxic epidermal necrolysis (TEN) Similar to SJS but >30% epidermal detachment Antibacterial sulfonamides, oxicam NSAIDs, anticonvulsants, allopurinol


Organ-specific reactions Clnical features Implicated medications
Hematologic Hemolytic anemia, thrombocytopenia, granulocytopenia Penicillin, quinine, sulfonamides
Hepatic Hepatitis, cholestatic jaundice Para-aminosalicylic acid, sulfonamides, phenothiazines
Pulmonary Pneumonitis, fibrosis Nitrofurantoin, bleomycin, methotrexate
Renal Interstitial nephritis, membranous glomerulonephritis Penicillin, sulfonamides, gold, penicillamine, allopurinol


Multiorgan reactions Clnical features Implicated medications
Anaphylaxis Urticaria, angioedema, bronchospasm, gastrointestinal symptoms, hypotension
IgE- and non–IgE-dependent reactions
β-lactam antibiotics, monoclonal antibodies
Drug reaction with eosinophilia and systemic symptoms (DRESS) Cutaneous eruption, fever, eosinophilia, hepatic dysfunction, lymphadenopathy Anticonvulsants, sulfonamides, minocycline, allopurinol
Serum sickness Urticaria, arthralgia, fever Heterologous antibodies, infliximab
Systemic lupus erythematosus Arthralgia, myalgias, fever, malaise Hydralazine, procainamide, isoniazid
Vasculitis Cutaneous or visceral vasculitis Hydralazine, penicillamine, propylthiouracil


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References

  1. Khan, David A. (2010-02). "Drug allergy". The Journal of Allergy and Clinical Immunology. 125 (2 Suppl 2): –126-137. doi:10.1016/j.jaci.2009.10.028. ISSN 1097-6825. PMID 20176256. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)