{"id":996,"date":"2023-01-06T01:55:41","date_gmt":"2023-01-06T06:55:41","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/?post_type=chapter&p=996"},"modified":"2023-01-13T15:29:24","modified_gmt":"2023-01-13T20:29:24","slug":"other-drug-eruptions","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/chapter\/other-drug-eruptions\/","title":{"raw":"Other Drug Eruptions","rendered":"Other Drug Eruptions"},"content":{"raw":"\r\nFixed drug eruption<\/strong> is a localized drug reaction that occurs in the same spot every time a patient is exposed to the responsible medication. It presents as a painful red plaque, that can blister and often leaves behind darkened skin. With subsequent re-exposures to the medication, more sites may become involved. In addition to antibiotics such as tetracyclines and trimethoprim-sulfamethoxazole, common causes include NSAIDs and acetaminophen.\r\n\r\n \r\n\r\n[caption id=\"attachment_1006\" align=\"aligncenter\" width=\"300\"]\"\" Image 11.5: Fixed drug eruption: Erythema, dusky center, and bulla formation[\/caption]\r\n\r\n<\/div>\r\n
\r\n\r\nDrug-induced hyperpigmentation<\/strong> is the development of darkened skin due to medication use. Several medications can cause this including antimalarials (e.g. hydroxychloroquine), minocycline and certain types of chemotherapy. The colour changes range from brown to shades of blue and gray. The distribution might be widespread, occur in site of previous rash or scars, or favour sun-exposed areas. The nails may also be affected (melanonychia, see Ch. 14 for a photo). It typically resolves slowly after discontinuation of the medication. Luckily, the discolouration is only of cosmetic concern and does not cause any harm.\r\n\r\n<\/div>\r\n
\r\n\r\n \r\n\r\n<\/div>\r\n\r\n\r\nDrug-induced acne<\/strong>. Any topical ointment may lead to worsening acne by\u00a0 clogging pores. Inappropriate use of topical corticosteroids may also cause acne or rosacea on the face. Retinoinds can lead to a flare of acne when they are first started, so patients should be counselled that things might get \u201cworse before they get better\u201d. Systemic corticosteroids, lithium, phenytoin and iodides (found in contrast media) are common causes of drug-induced acne in addition to those listed below. Anabolic steroids may also worsen acne. Drug-induced acne often presents with acute flare and monomorphous (all similar to each other) skin lesions. Sometimes systemic steroids lead to Malassezia folliculitis that resembles acne, but has no associated comedones. Psoriasis may also be triggered or worsened by certain medications including lithium, beta-blockers and antimalarials (e.g. hydroxychloroquine). Though TNF inhibitors are often used to treat psoriasis, in some cases, they may paradoxically cause it to flare when used to treat other conditions, such as inflammatory bowel disease.\r\n\r\n \r\n\r\n[caption id=\"attachment_1007\" align=\"aligncenter\" width=\"300\"]\"\" Image 11.6: Steroid induced acne with monomorphous inflammatory papules on the chest[\/caption]\r\n\r\n<\/div>","rendered":"

Fixed drug eruption<\/strong> is a localized drug reaction that occurs in the same spot every time a patient is exposed to the responsible medication. It presents as a painful red plaque, that can blister and often leaves behind darkened skin. With subsequent re-exposures to the medication, more sites may become involved. In addition to antibiotics such as tetracyclines and trimethoprim-sulfamethoxazole, common causes include NSAIDs and acetaminophen.<\/p>\n

 <\/p>\n

\"\"
Image 11.5: Fixed drug eruption: Erythema, dusky center, and bulla formation<\/figcaption><\/figure>\n
\n

Drug-induced hyperpigmentation<\/strong> is the development of darkened skin due to medication use. Several medications can cause this including antimalarials (e.g. hydroxychloroquine), minocycline and certain types of chemotherapy. The colour changes range from brown to shades of blue and gray. The distribution might be widespread, occur in site of previous rash or scars, or favour sun-exposed areas. The nails may also be affected (melanonychia, see Ch. 14 for a photo). It typically resolves slowly after discontinuation of the medication. Luckily, the discolouration is only of cosmetic concern and does not cause any harm.<\/p>\n<\/div>\n

\n

 <\/p>\n<\/div>\n

Drug-induced acne<\/strong>. Any topical ointment may lead to worsening acne by\u00a0 clogging pores. Inappropriate use of topical corticosteroids may also cause acne or rosacea on the face. Retinoinds can lead to a flare of acne when they are first started, so patients should be counselled that things might get \u201cworse before they get better\u201d. Systemic corticosteroids, lithium, phenytoin and iodides (found in contrast media) are common causes of drug-induced acne in addition to those listed below. Anabolic steroids may also worsen acne. Drug-induced acne often presents with acute flare and monomorphous (all similar to each other) skin lesions. Sometimes systemic steroids lead to Malassezia folliculitis that resembles acne, but has no associated comedones. Psoriasis may also be triggered or worsened by certain medications including lithium, beta-blockers and antimalarials (e.g. hydroxychloroquine). Though TNF inhibitors are often used to treat psoriasis, in some cases, they may paradoxically cause it to flare when used to treat other conditions, such as inflammatory bowel disease.<\/p>\n

 <\/p>\n

\"\"
Image 11.6: Steroid induced acne with monomorphous inflammatory papules on the chest<\/figcaption><\/figure>\n","protected":false},"author":1682,"menu_order":5,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-996","chapter","type-chapter","status-publish","hentry"],"part":986,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/996","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/users\/1682"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/996\/revisions"}],"predecessor-version":[{"id":1442,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/996\/revisions\/1442"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/parts\/986"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/996\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/media?parent=996"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapter-type?post=996"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/contributor?post=996"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/license?post=996"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}