Drug Hypersensitivity

Drug hypersensitivity reactions are a common clinical problem which may affect a considerable number of the treated patient population. Between 10 and 15% of patients may suffer from an unwanted drug reaction, 2–5% of these have to be hospitalized, and in 1–3% of hospitalized patients mortality may result.

Drug hypersensitivity reactions are systemic reactions which often involve the skin. Cutaneous manifestations may be the only clinically relevant presentation of a drug hypersensitivity, but the skin can also act to herald for example a systemic hypersensitivity reaction such as anaphylaxis or the severe drug hypersensitivity syndrome (drug rash with eosinophilia and systemic symptoms.

Particularly the hypersensitivity reactions are presented with symptoms and signs which are typically not related to pharmacologic doses and effects of the eliciting drugs. Therefore, drug hypersensitivity reactions present a complex challenge for treating physicians and the diagnosing allergist. To arrive at a useful final diagnosis, a structured stepwise approach is required. Drug hypersensitivity reactions can occur during all types of medical treatments, including biological, their additives, physiotherapeutic remedies or their adulterated contents. It is of utmost importance that the initial diagnosis is done carefully including some laboratory analysis, in particular an involvement of blood cells, and the affection of internal organs, such as liver and kidneys, should be excluded by appropriate blood tests (differential blood count, liver enzyme analysis, etc.).

Actually, it is advisable to consult a dermatologist or alternatively to take a photograph of the exanthema and of the particular cutaneous efflorescence’s, and to note all drugs taken during the last 2 weeks and particularly all newly introduced drugs taken within the last 4 weeks. A skin biopsy for histological examination may be helpful to further differentiate the exanthema. http://healthcareatm.com/