Drug Eruptions in Pigmented Skin

  • Baraka M. Chaula


Cutaneous adverse reactions to drugs are not uncommon. Clinical presentations on the skin are highly variable and can lead to serious clinical complications, be even lethal. The main challenge in managing these conditions is identifying the responsible drug. Currently, there is no definitive diagnostic test that can be applied to the wide range of the entities arising due to drug intolerance; the experienced physician has to reach clinical diagnosis.


  1. 1.
    Ditto AM. Drug allergy. In: Grammer LC, Greenberger PA, editors. Patterson’s allergic disease. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 295.Google Scholar
  2. 2.
    Nakamura M, Henderson M, Jacobsen G, et al. Comparison of photodermatoses in African-Americans and Caucasians: a follow-up study. Photodermatol Photoimmunol Photomed. 2014;30:231–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Saka B, Bauro-Traore F, Atadokpele FA, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa: a multicentric study in four countries. Int J Dermatol. 2013;52:575–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Husain Z, Reddy BY, Schwartz RA. DRESS syndrome. J Am Acad Dermatol. 2013;68:693–719.CrossRefPubMedGoogle Scholar
  5. 5.
    Aihara M. Pharmacogenetics of cutaneous adverse drug reactions. J Dermatol. 2011;38:246–54.CrossRefPubMedGoogle Scholar
  6. 6.
    Shear NH, Spielberg SP. Anticonvulsant hypersensitivity syndrome: in vitro assessment of risk. J Clin Invest. 1988;82:1826–32.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Chung WH, Hung SI, Chen YT. Human leukocyte antigens and drug hypersensitivity. Curr Opin Allergy Clin Immunol. 2007;7:317–23.CrossRefPubMedGoogle Scholar
  8. 8.
    Descamps V, Valence A, Edlinger C, et al. Association of human herpes virus 6 infection with drug with drug reaction with eosinophilia and systemic symptoms. Arch Dermatol. 2001;137:301–4.PubMedGoogle Scholar
  9. 9.
    Kano Y, Inaoka M, Shiohara T. Association between anticonvulsant hypersensitivity syndrome and human herpes 6 reactivation and hypogammaglobulinemia. Arch Dermatol. 2004;140:183–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Freedberg IM, Eisen AZ, Wolff K, et al. Fitzpatrick dermatology in general medicine. 5th ed. New York, NY: McGraw-Hill; 1999. p. 534–7.Google Scholar
  11. 11.
    Sterry W, Steinhoff M. Erythroderma. In: Bologna J, Jorizzo JL, Shaffer JV, editors. Dermatology. 3rd ed. Philadelphia: Elsevier-Saunders; 2012. p. 171–81.Google Scholar
  12. 12.
    Salami TA, Enahoro Oziegbe O, Omeife H. Exfoliative dermatitis: patterns of clinical presentation in a tropical rural and sub-urban dermatology practice in Nigeria. Int J Dermatol. 2012;51:1086–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Lehloenya RJ. Outcomes of reintroducing anti-tuberculosis drugs following cutaneous adverse drug reactions. Int J Tuberc Lung Dis. 2011;15:1649–57.CrossRefPubMedGoogle Scholar
  14. 14.
    Akhyani M, Ghoshi ZS, Toosi S, et al. Erythroderma: a clinical study of 97 cases. BMC Dermatol. 2005;5:5.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: part I. Introduction, classification. Clinical features, systemic manifestations, etiology, immunopathogenesis. J Am Acad Dermatol. 2013;69:173–81.PubMedGoogle Scholar
  16. 16.
    Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: part II prognosis, sequelae, diagnosis, differential diagnosis, prevention and treatment. J Am Acad Dermatol. 2013;69:187.PubMedGoogle Scholar
  17. 17.
    Borgiani P, Di Fusco D, Erba F, et al. Eur J Clin Pharmacol. 2014;70(3):275–8.Google Scholar
  18. 18.
    Dube N, Adewusi E, Summers R. Risk of nevirapine-associated Stevens-Johnson syndrome among HIV-infected pregnant women: the Medunsa National Pharmacovigilance Centre, 2007–2012. S Afr Med J. 2013;103:322–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Newell BD, Monifar M, Mancini AJ, et al. Retrospective analysis of 32 pediatric patients with anticonvulsant hypersensitivity syndrome (ACHSS). Pediatr Dermatol. 2009;26:536–46.CrossRefPubMedGoogle Scholar
  20. 20.
    Covin JH, Sheth AP. Minocycline hypersensitivity syndrome with hypotension mimicking septic shock. Pediatric Dermatol. 2001;18:295–8.CrossRefGoogle Scholar
  21. 21.
    Downey A, Jackson C, Harun N, et al. Toxic epidermal necrolysis: review of pathogenesis and management. J Am Acad Dermatol. 2012;66:995–1003.CrossRefPubMedGoogle Scholar
  22. 22.
    Shiga S, Cartotto R. What are the fluid requirements in toxic epidermal necrolysis? J Burn Care Res. 2010;31:100–4.CrossRefPubMedGoogle Scholar
  23. 23.
    Trent JT, Kirsner RS, Romanelli P, et al. Analysis of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis using SCORTEN: the University of Miami experience. Arch Dermatol. 2003;139:39–43.PubMedGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Baraka M. Chaula
    • 1
  1. 1.Dermatology Unit, Department of Internal MedicineMbeya Zonal Referral HospitalMbeyaTanzania

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