Exanthematous Drug Eruption

• ERD is an adverse hypersensitivity reaction to

an ingested or parenterally administered drug
• Cutaneous eruption that mimics a measles like
viral exanthem

Sumber : Fitzpatrick’s color atlas & synopsis of clinical dermatology sixth

edition
 Etio dan patfis
• Drugs with a high probability of reaction :
penicillin and related antibiotics,
carbamazepine,allopurinol
• Medium probability: sulfonamides,NSAIDs,
isoniazis, chloramphenicol,erythromycin,
streptomycin
• Low probability:
benzodiazepine,tetracyclines,phenothiazines
• Exact mechanism unknown. Probably delayed
hypersensitivity
Sumber : Fitzpatrick’s color atlas & synopsis of clinical dermatology sixth
edition
 Gejala timbul
• Sensitization occurs during administration or
after completing course of drug: peak incidence
at ninth day after administration. However, EDR
may occur at any time between the first day and
3 weeks after beginning of treatment. Reaction to
penicillin can begin >2 weeks after drug is
discontinued.
• In previously sensitized patient, eruption starts
within 2 or 3 days after readministration of drug
Sumber : Fitzpatrick’s color atlas & synopsis of clinical dermatology sixth
edition
• Systems review: fever, chills
• Skin lesions macules and/or papules, a few
milimeters to 1 cm in size
• In time lesions become confluent forming
large macules, polycyclic erythema
• Distribution symmetric. Always on trunk and
extremities. Confluent lessions in
intertriginous areas
Sumber : Fitzpatrick’s color atlas & synopsis of clinical dermatology sixth
edition
 Pemeriksaan penunjang
• Lab : peripheral eosinophilia
• Dermatopathology: perivascukar lymphocytes
and eosinophils
terapi : oral antihistamine to alleviate pruritus
Glucocorticoids: oral or IV provides symptomatic
relief
Prevention: patients must be aware of their
specific drug hypersensitivity and that other
drugs of the same class can cross react
Sumber : Fitzpatrick’s color atlas & synopsis of clinical dermatology sixth
edition
 Tinea fasialis

• In pediatric and female patients, the infection

may appear on any surface of the face, including
the upper lip and chin. In men, the condition is
known as tinea barbae when a dermatophyte
infection of bearded areas occurs.

• Etiologi : T.rubrum, T.mentagrophytes, M.canis

• Klinis: tipikal annular rings, fotosensif
• Keratinophilic fungi, or dermatophytes, are
responsible tinea faciei. Dermatophytes
release several enzymes, including
keratinases, which allow them to invade the
stratum corneum of the epidermis. Infection
caused by zoophilic dermatophytes is usually
associated with inflammatory reactions that
are more severe than those due to
anthropophilic fungi.
Sumber: medscape
• Terapi : bila terdapat fungal folliculitis
dibutuhkan obat oral antifungal
• No folliculitis-> topikal terapi
• The prognosis for patients with tinea faciei is
usually good. The lesions respond to topical
and oral antifungal treatment within 4-6
weeks.

Sumber: medscape