DRUG ERUPTIONS Treatment

The treatment of drug eruptions is simply to stop the offending drug, and to treat the eruption symptomatically until it disappears. If the patient is very ill, intravenous or oral corticosteroid treatment may be required. The difficulty is in knowing which eruptions are due to drugs. Vivid widespread erythemas will be recognized easily, but there are many occasions when the eruption mimics or produces a commonplace dermatosis such as the urticaria caused by acetylsalicylic acid, erythema multiforme due to barbiturates, erythema nodosum due to sulphonamides and acneiform eruptions due to bromides or iodides. There are also patterns of eruption which are familiar to the dermatologist but not generally known. These are the bizarre purpura which shows a dependent distribution that is characteristic of carbromal sensitivity. Again there is the curious phenomenon of the fixed drug eruption. An erythematous or somewhat livid patch recurs intermittently in the same of skin over a period of many months. It is usually caused by taking phenol-phthalein—perhaps very infrequently—but sometimes other drugs such as quinine, barbiturates, analgesics and antibiotics are responsible. There are other occasions when an eruption is accompanied by a severe toxic illness perhaps with fever, lymphadenopathy and arthropathy. The constitutional upset may be so severe that comparatively little attention is paid to the skin eruption, and the correct diagnosis of drug sensitivity may thus be missed.