From the Guidelines
A medication-induced rash is commonly referred to as a cutaneous adverse drug reaction (CADR) or drug eruption. This condition occurs when the body's immune system reacts to a medication, treating it as a foreign substance. According to the guidelines for using antiretroviral agents among HIV-infected adults and adolescents 1, skin rash is a common side effect of certain medications, particularly those in the NNRTI class of drugs. The majority of cases are mild to moderate, occurring within the first weeks of therapy.
- Common culprits of medication-induced rash include antibiotics, anticonvulsants, NSAIDs, and allopurinol.
- Severe forms of medication-induced rash include Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) 1.
- If a rash develops after starting a new medication, it is essential to contact a healthcare provider immediately, as some drug reactions can become serious.
- The use of systemic corticosteroid or antihistamine therapy at the time of initiation of certain medications to prevent development of skin rash has not proven effective and may even increase the incidence of skin rash 1.
- In cases of severe cutaneous manifestations, such as Stevens-Johnson syndrome or toxic epidermal necrosis, the offending agent should be promptly and permanently discontinued 1.
From the FDA Drug Label
ADVERSE REACTIONS ... General: Urticaria, drug rash, anaphylactic shock, photosensitivity, excessive perspiration, chills, dryness of mouth, nose and throat.
Medication-induced rash is called drug rash 2.
From the Research
Medication-Induced Rash
Medication-induced rash is a common adverse reaction to drugs, and it can occur in various forms, including:
- Exanthems, which are a type of skin eruption that can be caused by drugs 3
- Fixed drug eruption (FDE), which is a cutaneous adverse drug reaction characterized by the onset of rash at a fixed location on the body each time a specific medication is ingested 4
- Acute generalized exanthematous pustulosis (AGEP), which is a drug-induced skin eruption that typically presents within two days of starting an offending medication 5
- Annular drug eruptions, which are cutaneous adverse drug reactions that can present with annular, polycyclic, or polymorphous configurations 6
Types of Medication-Induced Rash
Some common types of medication-induced rash include:
- Morbilliform erythema, which is a type of rash that is often associated with drug reactions 3
- Urticaria and angioedema, which are types of allergic reactions that can cause rash 3
- Erythema multiforme, which is a type of skin eruption that can be caused by drugs 3
- Vasculitic rashes, which are types of rashes that can be caused by drugs and can involve the blood vessels 3
Importance of Identification
It is essential to identify medication-induced rash correctly, as some types of rashes can be life-threatening, such as Stevens-Johnson syndrome and toxic epidermal necrolysis 7, 3, 6. Early recognition and supportive measures are crucial in managing medication-induced rash, and in some cases, prompt treatment can be life-saving 3, 6.