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2288 pages added, reviewed or updated during the last month (last updated: 19/4/2021)


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different types (and timing) of drug allergic (allergy) reactions

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Signs and allergic patterns of suspected drug allergy with timing of onset

Immediate, rapidly evolving reactions

  • Anaphylaxis - a severe multi-system reaction characterised by:
    • erythema, urticaria or angioedema and
    • hypotension and/or bronchospasm
  • Urticaria or angioedema without systemic features
  • Exacerbation of asthma (for example, with non-steroidal anti-inflammatory drugs [NSAIDs])
Onset usually less than 1 hour after drug exposure (previous exposure not always confirmed)

Non-immediate reactions without systemic involvement

  • Widespread red macules or papules (exanthema-like)
  • Fixed drug eruption (localised inflamed skin)
Onset usually 6-10 days after first drug exposure or within 3 days of second exposure

Non-immediate reactions with systemic involvement

Drug reaction with eosinophilia and systemic symptoms (DRESS) or drug hypersensitivity syndrome (DHS) characterised by:

  • widespread red macules, papules or erythroderma
  • fever
  • lymphadenopathy
  • liver dysfunction
  • eosinophilia
Onset usually 2-6 weeks after first drug exposure or within 3 days of second exposure

Toxic epidermal necrolysis or Stevens-Johnson syndrome characterised by:

  • painful rash and fever (often early signs)
  • mucosal or cutaneous erosions vesicles, blistering or epidermal detachment
  • red purpuric macules or erythema multiforme
Onset usually 7-14 days after first drug exposure or within 3 days of second exposure

Acute generalised exanthematous pustulosis (AGEP) characterised by:

  • widespread pustules
  • fever
  • neutrophilia
Onset usually 3-5 days after first drug exposure

Common disorders caused, rarely, by drug allergy:

  • eczema
  • hepatitis
  • nephritis
  • photosensitivity vasculitis
Time of onset variable

 

Reference:

Last reviewed 01/2018

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