Skip to Main Content


Therapeutic Approach

Cutaneous reactions to drugs or cutaneous adverse drug reactions (CADR) range from simple drug exanthems limited solely to the skin to rare, life-threatening reactions due to systemic involvement, such as acute generalized exanthematous pustulosis (AGEP), drug reaction eosinophilia and systemic symptoms (DReSS), or toxic epidermal necrolysis (TEN). Immediate withdrawal of the offending drug (careful attention should be paid to all medications taken in the 8 weeks prior to the event) and supportive care is the most crucial management aspect. Medications that may decrease the elimination of the culprit drug should be discontinued as well. Treatment setting and adjuvant medications should be decided on a case-by-case basis.

The authors typically treat mild CADR with topical corticosteroids (high to super-high potency), antihistamines, and supportive care while systemic corticosteroids are added based on the patient’s clinical response and evolution. For DReSS cases, hospitalization is recommended to closely monitor visceral involvement and systemic corticosteroids are typically added regardless its severity.

Patients who have developed a severe CADR should not be rechallenged with the offending drug. See Table 31-1.

Table 31-1Cutaneous Adverse Drug Reactions Treatment Table

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.