Cutaneous adverse cutaneous drug reactions (CADRs) are common among the pediatric population. Although they are rarely considered serious, CADRs account for approximately 35 % of all adverse drug reactions. Because viral exanthems are extremely common in children, clinicians are often faced with a diagnostic dilemma when children are taking many medications and present with a rash. If a child is taking numerous medications, establishing causality to a specific drug can be multifaceted and difficult. We discuss the most common pediatric drug eruptions according to the pattern of the cutaneous eruption: urticarial, exanthematous, pustular, and vesicobullous. We also include a miscellaneous group for completeness. Proper management of a CADR requires an efficient method of accurately estimating the probability of a drug association, determining the likelihood of a relapse with drug re-challenge, and relaying this information to patients and their families. A hasty diagnosis of a drug “allergy” will follow a child through his or her life, and possibly increase their exposure to more toxic medications unnecessarily. Unless a re-challenge is performed, the vast majority of CADRs in children can only be considered as possibly associated with a drug.
KeywordsPediatric cutaneous drug eruption Drug reaction Cutaneous adverse drug reactions (CADRs) Urticarial Exanthematous Pustular Vesicobullous
- Lansang P, Weinstein M, Shear N. Drug reactions. In: Schachner LA, Hansen RC, editors. Pediatric dermatology. 4th ed. London: Mosby Elsevier; 2011. p. 1698–711.Google Scholar
- Ott H. Hypersensitivity reactions to drugs. In: Irvine AD, Hoeger PH, Yan AC, editors. Harper’s textbook of pediatric dermatology. 3rd ed. Oxford: Blackwell Publishing Ltd; 2011. p. 2816.Google Scholar
- Patel S, Mancini AJ. Serum sickness-like reaction in children: a retrospective review. J Am Acad Dermatol. 2009;60 Suppl 1:AB1–276.Google Scholar
- Revuz J, Valeyrie-Allanore L, et al. Drug reactions in dermatology. In: Jean L, Bolognia M, Julie V, editors. Dermatology. 3rd ed. Philadelphia: Elsevier Inc; 2012. p. Cp21.Google Scholar
- White-Koning M, Civade E, Geoerger B, Thomas F, Le Deley MC, Hennebelle I, et al. Population analysis of erlotinib in adults and children reveals pharmacokinetic characteristics as the main factor explaining tolerance particularities in children. Clin Cancer Res. 2011;17(14):4862–71.CrossRefPubMedGoogle Scholar