Dermatology

- any medication has the potential to cause an adverse rxn
- common offenders include antibiotics, NSAIDs, anti-hypertensive meds, anti-seizure meds, and Rx pain meds
- Morbilliform (maculopapular) rashes and urticarial reactions are the most common drug eruptions
- Perform a punch biopsy on an active site to help confirm the diagnosis - send specimen to dermatopathologist
- communicated w/physician who prescribed the suspected drug before stopping any medication
- recommend a drug be stopped one at a time for 4-6 weeks to see if rash resolves

Drug eruptions: Morbillifom

Drug eruption: diffuse

Drug eruption: diffuse

Drug eruption: urticarial

Drug eruption: vesicles

Drug eruption: photodermatitis

- antibiotics: PCN, Sulfas, cephalosporins
- diuretics: photosensitivity drug rxns ex. HCTZ
- NSAIDs: fixed drug eruption, vasculitis
- Anticonvulsants: Stevens-Johnson Syndrome

Stevens-Johnson Syndrome (Erythema Multiforme Major) with mucocutaneous involvement

Will present with widespread rash and lesions in eyes, mouth, and nose.

- Discontinue the offending drug
- Antihistamines for pruritis
- Short course of prednisone tapered if necessary
- Moisturizers to reduce infection
- Oral or topical antibiotics if suspect secondary infection from scratching

- Common childhood diseases
(usually benign and go away on their own, with only some exceptions)
- Vaccinations important for reducing epidemics (MMR)
- Usually preceeded by a prodrome of fever and constitutional symptoms

- Prodrome: 3 C's
1. cough
2. coryza (head cold)
3. conjunctivitis

Also will have fever, fatigue, and arthralgias

Measles (rubeola)

Rash begins 3-4 days

Measles (rubeola)