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Exanthematous drug eruption in Child
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Exanthematous drug eruption in Child

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Contributors: Craig N. Burkhart MD, Dean Morrell MD
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Synopsis

Exanthematous drug eruption : Rash, Reaction 0 to 5 days after drug, Reaction 6 to 30 days after drug, Widespread distribution, Pruritus
Exanthematous, or morbilliform, eruptions are the most common of all medication-induced eruptions. They consist of red blanching macules and papules that begin on the head and trunk and spread symmetrically caudally and to the proximal extremities. In severe eruptions, lesions coalesce and may lead to generalized erythroderma. Palms, soles, and mucous membranes may also be involved. Pruritus is common, and fever may occur in more severe reactions.

Onset is usually within 7-14 days of initiating a medication, although it is not uncommon for exanthematous penicillin reactions to develop after 2 weeks from the onset of exposure. Scarlatiniform (pinpoint papular), sandpapery-feeling erythematous lesions may also be caused by medications. In dark-skinned children, postinflammatory hyper- or hypopigmentation may take weeks to months to resolve.

Almost any oral agent can cause an exanthematous reaction, but they are most commonly seen with the use of antibiotics (penicillins and sulfas), allopurinol, phenytoin, barbiturates, chlorpromazine, carbamazepine, gold, d-penicillamine, captopril, naproxen, and piroxicam, among others.

Codes

ICD10CM:
L27.0 – Generalized skin eruption due to drugs and medicaments taken internally

SNOMEDCT:
238814003 – Maculopapular drug eruption

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:05/30/2017
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Exanthematous drug eruption in Child
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A medical illustration showing key findings of Exanthematous drug eruption : Rash, Reaction 0 to 5 days after drug, Reaction 6 to 30 days after drug, Widespread distribution, Pruritus
Clinical image of Exanthematous drug eruption - imageId=2811647. Click to open in gallery. caption: 'Widespread erythematous papules and plaques on the abdomen.'
Widespread erythematous papules and plaques on the abdomen.

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