What are the principles for medical management of drug eruptions?

Updated: Feb 15, 2019
  • Author: Jonathan E Blume, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Principles of medical care are as follows:

  • The ultimate goal is to identify and discontinue the offending medication if possible

  • Patients can sometimes continue to be treated through morbilliform eruptions; nevertheless, all patients with severe morbilliform eruptions should be monitored for mucous membrane lesions, blistering, and skin sloughing

  • Treatment of a drug eruption depends on the specific type of reaction

  • Therapy for exanthematous drug eruptions is supportive, involving the administration of oral antihistamines, topical steroids, and moisturizing lotions

  • Severe reactions (eg, SJS, TEN, and hypersensitivity reactions) warrant hospital admission

  • TEN is best managed in a burn unit, and intravenous immunoglobulin (IVIG) may improve outcomes [3, 4, 5]

  • Hypersensitivity syndrome may have to be treated with liver transplantation if the offending drug is not stopped in time; treatment with systemic corticosteroids has been advocated in the acute phase; in the chronic phase, patients may require treatment for hypothyroidism or diabetes mellitus


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