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Allergic and Immunologic Reactions
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Saira N. Agarwala, Aspen R. Trautz, Sylvia Hsu
Definition: Morbilliform drug eruptions are the most common type of drug hypersensitivity reaction. The word morbilliform stems from the measles-like macules and papules that characterize the drug reaction.
Other viral infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
As with many viral infections, infection with human parvovirus B19 may be asymptomatic or carry symptoms of only a mild flu-like illness. The rash is more common in children than in adults but adults are more likely to develop arthritic complaints. The rash is characterized as a lacy rash especially on the face providing the “slapped cheek” appearance. A variable rash on the extremities may follow with a morbilliform, confluent, circinate, or annular appearance. This usually does not involve the trunk, palms, or soles and may be pruritic. The rash usually disappears within 1 to 2 weeks but may recur especially with stress, exercise, sunlight, or bathing (34,35).
Kawasaki disease
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Day 3 Developed rash within few hours of starting penicillin so mum stopped medicine. O/e morbilliform rash on abdomen and chest. Mild scarlatiniform rash on arms and legs. Throat remains injected and conjunctiva slightly improved.? Scarlet fever.? Reaction to penicillin. Throat swab taken and treatment switched to erythromycin. To be continued for 10 days.
Dermatologic adverse events associated with targeted therapies for melanoma
Published in Expert Opinion on Drug Safety, 2022
Luigi Scarpato, Lucia Festino, Vito Vanella, Gabriele Madonna, Massimo Mastroianni, Marco Palla, Paolo Antonio Ascierto
These are skin adverse events mostly related to MEK inhibitors and they represent a different grade of aseptic immune-cell invasion of epidermis and hair follicles that often lead to bacterial suprainfections. The follicular/maculo-papular/acneiform eruption could be considered an evolution of hair follicle immune infiltration and consists of itchy follicles and papules that could evolve into pustules or acneiform eruption. Pustules may lead to crusts and hyperkeratosis. The head, neck, trunk, and proximal upper extremities are the main distribution areas [66]. The morbilliform eruption is characterized by diffuse itching and symmetric eruption of erythematous macules or small papules, mainly involving the trunk and the upper and lower extremities. Grade severity is based on the body surface area (BSA) involved and the degree of limitation in performing daily living activities (ADL) [72]. Maculo-papular exanthem covering 10–30% of BSA with systemic symptoms and lymphadenopathy can be treated with topical emollients, oral antihistamines and medium-to-high strength topical corticosteroids. Sometimes it is possible to add prednisone (or equivalent) 0.5–1 mg/kg when tapered over at least 4 weeks. The mucosal involvement with mucous membrane detachment warrants a burn consultation with attention to supportive care including fluid and electrolyte, and administration of a methylprednisolone (or equivalent) i.v. 0,5–1 mg/kg converting to oral corticosteroids on response. The use of immunosuppressants should be considered in the case of steroid resistance.
Cutaneous manifestations of COVID-19 in skin of color: a firsthand perspective of three cases in a tertiary care center in India
Published in Postgraduate Medicine, 2021
Shivam Goyal, Smitha Prabhu, Shashikiran U, Sathish B. Pai, Afsal Mohammed
Exanthematous or morbilliform rash has been noted mostly on the trunk, either at disease onset or at the time of recovery [4]. Pernio (chilblain)-like acral lesion or ‘COVID toes’ present across the age spectrum as purpuric or erythematous macules over fingers, elbows, toes, and lateral aspect of feet [5]. Resolution occurs in 2 to 8 weeks. Rarely, it can progress to recalcitrant digital ischemia [6]. Acute urticaria is the next common finding noted with or without concomitant fever [1–3,11]. The varied cutaneous findings have also been described in pregnancy in a case report where maculopapular rash and urticaria-like lesions were simultaneously present [7]. Recently HZ has been suggested as an alarming sign for a recent subclinical SARS CoV2 infection [8,9]. Retiform purpura has also been described as one of the cutaneous findings [10].
Baclofen-induced toxicity in renal disease with neurotoxicity and skin rash
Published in Baylor University Medical Center Proceedings, 2019
Lakshmi Kant Pathak, Ambarish Athavale, Ian Martinez
In very rare cases, toxicity can present as a morbilliform rash that tends to improve with withdrawal of the medication. In a published series of four cases, patients who were treated with baclofen for alcohol dependence developed a morbilliform rash at different treatment doses, indicating that the rash was dose independent and an idiosyncratic reaction.4 Baclofen has a low molecular weight, low volume distribution, and low protein binding capacity, making it easy to dialyze. Although the percentage of clearance varies with each person and the duration of hemodialysis session, it can be up to 79% cleared in one treatment session, with rapid neurological improvement after two sessions.5