Drug Rashes

Overview

Certain classes of medicines (groups of medicines that are similar, but not exactly the same) are known to cause reactions in some people. Any medicine or medicine class can cause a drug rash, however reactions occur more often in the following:

• Anticonvulsants (used to control seizures)
• Medicines used to control human immunodeficiency virus (HIV)
• Sulfonamides (a class of antibiotics)

Prescription drug reactions do not happen often, and when they do, the reaction often goes away soon after you stop taking the medication. Be sure to ask your physician about possible reactions before you take any prescription. Knowing what to watch for can help you respond quickly if you do have a rare, but potentially serious reaction.

Not all drug rashes need to be treated. Sometimes a rash may cause only mild discomfort and have no effect on internal organs. If the drug works well, you may choose to tolerate the rash as a minor side effect. In other cases the rash or other symptoms may be more noticeable, and treatment may be necessary.

Treatment

Depending on how mild or severe your reaction to medicine is, your treatment may include:

Medicine Elimination

In some cases the rash or other symptoms may be bothersome, but will go away when you simply stop taking the medicine. It may take a week or two for your rash to disappear completely. Always notify your physician if you need to stop a medication.

Diphenhydramine

Mild allergic skin reactions such as hives can be treated at home with diphenhydramine (Benadryl).

Corticosteroids

For more serious drug rashes, anti-inflammatory drugs may be needed to stop your symptoms.

Epinephrine

Anaphylaxis is a serious reaction that includes symptoms such as tightening of the chest, significant breathing difficulty, facial and oral swelling and unconsciousness. Anaphylaxis can happen in minutes or even seconds, and requires emergency treatment using corticosteroids and epinephrine (adrenaline) to overcome your reaction.

Treatment for Stevens-Johnson Syndrome

Stevens-Johnson syndrome is a potentially serious reaction that occasionally develops into a condition called toxic epidermal necrolysis (TEN). Symptoms of Stevens-Johnson syndrome include widespread blistering and peeling skin, sores in the mouth, and red and painful eyes. There may also be erosions in the mouth, and this severe reaction can affect internal organs. Other aspects of Stevens-Johnson syndrome are inflammation inside the eye and damage to the clear outer area of the eye, the cornea.

Treatment for Stevens-Johnson syndrome begins with a skin biopsy to confirm the diagnosis. Cyclosporine, a medicine used to keep your immune system from overreacting to drugs, is often the first medicine used to start counteracting symptoms. Because Stevens-Johnson syndrome includes severe skin damage, this syndrome is often treated as though you have widespread burns. Treatment includes pain medicines and skin grafts to cover areas where damaged skin has fallen away. If your eyes are involved significantly, your physicians will collaborate with ophthalmologists to care for the eye and minimize the chance of corneal scarring.