RT Book, Section
A1 Prendiville, Julie
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 7033178
T1 Chapter 362. Immunologic Diseases
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=7033178
RD 2024/04/25
AB Cutaneous  adverse  reactions  to  drugs  are  common  in  pediatric  practice  and  often  present  a  diagnostic  challenge.1  The  pathogenesis  of  most  drug  eruptions  is  not  well  understood.  With  the  exception  of  fixed  drug  eruption  (discussed  shortly),  a  diagnosis  of  drug  causation  cannot  be  based  solely  on  the  morphology  of  the  skin  lesions.2  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  such  as  penicillin.  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.