RT Book, Section
A1 Prendiville, Julie
A1 Treat, James R.
A2 Kline, Mark W.
SR Print(0)
ID 1182905480
T1 Immunologic Diseases
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182905480
RD 2024/04/20
AB Cutaneous  adverse  reactions  to  drugs  are  common  in  pediatric  practice  and  often  present  a  diagnostic  challenge.  The  pathogenesis  of  most  drug  eruptions  is  not  well  understood.  With  the  exception  of  fixed  drug  eruptions,  a  diagnosis  of  drug  causation  cannot  be  based  solely  on  the  morphology  of  the  skin  lesions.  A  high  index  of  suspicion  is  important  so  that  the  offending  drug  is  discontinued  and  avoided  in  the  future,  particularly  in  the  case  of  life-threatening  reactions  such  as  anaphylaxis,  the  drug  hypersensitivity  syndrome  (DHS),  and  Stevens-Johnson  syndrome  (SJS)  or  toxic  epidermal  necrolysis  (TEN).  Conversely,  it  is  important  not  to  erroneously  label  a  child  as  “allergic”  to  a  widely  used  medication.  There  are  no  standardized  laboratory  investigations  that  confirm  drug  causation,  and  the  value  of  allergy  testing  is  largely  restricted  to  cases  of  immunoglobulin  E  (IgE)-mediated  penicillin  hypersensitivity.  Therefore,  a  detailed  history,  evaluation  of  the  morphology  of  the  eruption,  consideration  of  a  differential  diagnosis,  and  careful  clinical  judgment  are  essential.