Cutaneous
drug eruptions are among the most common adverse reactions to
drug therapy. The etiology may reflect immunologic or nonimmunologic mechanisms, the former encompassing all of the classic Gell and Combs immune mechanisms. Cumulative and synergistic effects of drugs include those interactions of pharmacokinetic and pharmacodynamic factors reflecting the alteration by one
drug of the effective serum concentration of another and the functions of drugs and their metabolites that interact to evoke cutaneous and systemic adverse reactions. Recent observations include the role of concurrent
infection with lymphotropic viruses and
drug effects that, through the enhancement of lymphoid blast transformation and/or lymphocyte survival and the contribution of intercurrent systemic
connective tissue disease syndromes, promote enhanced lymphocyte longevity and the acquisition of progressively broadening
autoantibody specificities. The latter are particularly opposite to
drug-induced lupus erythematosus and to
drug reactions in the setting of
HIV infection. Specific common types of cutaneous
drug eruptions will be discussed in this review. Successful management of cutaneous
drug eruptions relies upon the prompt discontinuation of the causative medication; most
drug eruptions have a good prognosis after this is accomplished. Oral or topical
corticosteroids can be administered to aid in the resolution of some types of eruptions.
Antihistamines or
anti-inflammatory agents may also be administered for some eruptions.