Drug eruptions

Drug eruptions occur in up to 2% of hopitalized patients; most are minor irritations but, rarely, some are life-threatening. This article outlines a logical approach to identifying drug eruptions, their trigger and their management. Classification of the morphological type and the timing of their onset relative to initiation of the culprit drug are the most important factors in their recognition. The features that mark potentially life-threatening eruptions (Stevens–Johnson syndrome, toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms) are highlighted. Emerging problems of the pustular eruptions associated with epidermal growth factor receptor antagonists used in malignancy, and drug-induced ulcers caused by nicorandil and hydroxycarbamide are covered.