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Drug Induced Skin Disorders
Drug Induced Skin Disorders
Presentation by-
Gauri Agarwal (42)
Geetanshi Singh (43)
What are drug induced skin disorders?
They are defined as any skin disorder caused by a drug or medication.
It is estimated that 2-3% of hospitalized patients are affected by drug reactions and that serious drug reactions occurring in about 1 in 1000 patients.
Definition
and
Mechanism
MECHANISM
- Pharmacological
- caused by overdose, or failure to excrete or metabolize.
- altered skin ecology.
Mechanisms
- Allergic
- IgE mediated
- cytotoxic
- cell mediated
- Immune complex mediated
- Idiosyncratic
- Exacerbation of pre-existing skin conditions.
Urticaria and Pigmentation
- URTICARIA
It is defined as a skin disorder characterized by local transient skin or mucosal edema (wheal) and an area of redness (erythema) that typically accompany itchy sensations and diminish within a day.
Most commonly caused by salicylates.
Antibiotics also cause urticaria.
Insect repellants cause urticaria on contact.
It may be a part of a severe or generalized anaphylaxis reaction.
- PIGMENTATION
Skin color can be altered by drugs like hypopigmentation and hyperpigmentation.
Common
Skin
Reactions
Minocycline –may cause blue/black pigmentation within scars
Erythema and Eruptions
- Erythema
It is of two types:
1) Erythema multiforme : target like lesion may appear mainly on extensor aspect of limbs. eg. sulphonamides, barbituarates.
2) Toxic erythema : It is common and looks like measles. eg. Antibiotics (especially ampicillin), sulphonamides, barbituarates.
Erythema and
Eruptions
- Eruptions
It is of two types:
1) Acneiform eruptions : eg. OCPs, glucocorticoids, anti-TB therapy
2) Fixed drug eruptions : round, erythmatous or purple, bullous plaque recur at the same site as application of drug. eg. Paracet
Demographics
Purpura,
Eczema
and exfoliative
dermatitis
25
$40,000 - $80,000
25-45
Effect on hair growth
- Alopecia - hair loss
Predictable S/E of cytotoxic agents and sometimes seen with anti thyroid drugs.
Diffused hair loss may occur during or just after the use of an oral contraceptive.
Effect on
hair growth
- Hypertrichosis- excessive growth
Dose dependent effect of minodoxil and cyclosporin A