Danger signs in drug hypersensitivity.
ADRs are frequently considered iatrogenic complications and, therefore, pose a specific challenge for the physician-patient relationship. Early recognition of a potential ADR is possible, especially on the skin, in addition to characteristic clinical danger signs. Cutaneous manifestations are variable, depending on the causative pathomechanism. It is impossible to conclude the causative agent from the morphology of the cutaneous lesions. The intake of several drugs in the time before the elicitation of the drug reaction usually poses a diagnostic challenge. It is crucial for the precision of any further allergological work-up to document the type of rash precisely as well as the time course of drug intake and appearance of the first symptoms. involvement of internal organs or circulating blood cells. Timely recognition of such cutaneous lesions and the correct differential diagnosis with prompt withdrawal of the putative culprit drug are essential to reducing morbidity and preventing mortality. This article discusses risk factors, early symptoms, and danger signs indicating a possibly severe course of an ADR and advises on early actions.
Scherer
Kathrin
K
Allergy Unit, Department of Dermatology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. schererk@uhbs.ch
Bircher
Andreas J
AJ
D000799:Angioedema / Q000139:chemically induced / Q000175:diagnosis; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology; D052016:Mucositis / Q000139:chemically induced; D004366:Nonprescription Drugs / Q000009:adverse effects; D055553:Prescription Drugs / Q000009:adverse effects*; D012307:Risk Factors
D004366:Nonprescription Drugs; D055553:Prescription Drugs