Dermatological reactions

Ora/-Adverse reactions requiring discontinuation include Pulmonary infiltrates or fibrosis paroxysmal ventricular tachycardia CHF elevation of liver enzymes visual disturbances solar dermatitis blue discoloration of skin hyperthyroidism hypothyroidism. Adverse reactions occurring in at least 3% of patients include CFIF Gl complaints (nausea, vomiting, constipation, anorexia) dermatologic reactions (photosensitivity, solar dermatitis) neurologic problems (malaise, fatigue, tremor/abnormal involuntary movements, lack of coordination, abnormal gait/ataxia, dizziness, paresthesias) abnormal liver function tests. 

Pemphigoid rash Pemphigoid rash, the most serious dermatologic reaction occurs most often after 6 to 9 months of penicillamine. 

Dermatologic Severe dermatologic reactions, including toxic epidermal necrolysis (Lyell syndrome) and Stevens-Johnson syndrome, have been reported with carbamazepine. These reactions have been extremely rare however, a few fatalities have been reported. 

Hypersensitivity - Rare serious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis have occurred in patients on azithromycin therapy. 

Dermatological reactions Patients have rarely developed serious cutaneous reactions, such as Stevens-Johnson syndrome, during treatment with voriconazole. Photosensitivity Voriconazole has been infrequently associated with photosensitivity skin reaction, especially during long-term therapy. It is recommended that patients avoid strong, direct sunlight during voriconazole therapy. 

Skin - Severe, occasionally fatal dermatologic reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome, exfoliative dermatitis, skin necrosis, and erythema multiforme, have been reported within days of methotrexate administration. 

Dermatologic reactions Dermatologic reactions may occur exercise care when given to any patient receiving a drug with significant tendency to produce dermatitis. Toxic symptoms If serious toxic symptoms occur, administer ammonium chloride (8 g daily in divided doses for adults) 3 or 4 days a week for several months after therapy has been stopped acidification of the urine increases renal excretion by 20% to 90%. Exercise caution in renal function impairment and/or metabolic acidosis. 

GI upset, pancreatitis, dizziness, paresthesias, headache, blood dyscrasias, pulmonary edema, allergic pneumonitis, and dermatologic reactions occur rarely. 

Severe and possibly life-threatening dermatologic reactions, including Stevens-iohnson syndrome, occur rarely. 

Dermatological reactions to lithium include acne, follicular eruptions, and psoriasis. Hair loss and thinning also have been reported. Except for cases of exacerbation of psoriasis, these reactions are usually benign and may not warrant discontinuation of lithium treatment. Lithium-induced acne responds to topical treatment with retinoid acid, such as tretinoin (Retin-A). 

Early in the course of lithium therapy, exacerbations of psoriasis and acneiform eruptions as well as other skin reactions may occur. Possible mechanisms have included lithium s ability to decrease cAMP as well as to increase the number and activity of polymorphonuclear leukocytes. Those with a predisposition to skin disorders are most at risk for this complication, with women more likely than men to experience a dermatological reaction to lithium. These problems may clear spontaneously or may require lithium dose reduction, appropriate dermatological intervention, or lithium discontinuation ( 77). 

Livedo reticularis sometimes occurs in patients taking amantadine and usually clears within 1 month after the drug is withdrawn. Other dermatologic reactions have also been described. Peripheral edema, another well-recognized complication, is not accompanied by signs of cardiac, hepatic, or renal disease and responds to diuretics. Other adverse reactions to amantadine include headache, heart failure, postural hypotension, urinary retention, and gastrointestinal disturbances (eg, anorexia, nausea, constipation, and dry mouth). 

Unithiol has been reported to have a low overall incidence of adverse effects (< 4%). Self-limited dermatologic reactions (drug exanthems or urticaria) are the most commonly reported adverse effects, although isolated cases of major allergic reactions, including erythema multiforme and Stevens-Johnson syndrome, have been reported. Because rapid intravenous infusion may cause vasodilation and hypotension, unithiol should be infused slowly over an interval of 15-20 minutes. 

Adverse Reactions Fever (1 patient in 3) Chills (1 patient in 7) Leukopenia (1 patient in 7) Dermatologic reactions (1 patient in 8) Thrombocytopenia (1 patient in 9) Reported in>1%, but <5% of Patients Arthralgia Chest and/or back pain Clotted A/V fistula Nausea and/or vomiting Night sweats Pain at infusion site Peripheral thrombophlebitis Stomatitis... 

Adverse Reactions Fever Chills Leukopenia Pain/abdominal pain Headache Thrombocytopenia Dyspnea Malaise Dermatologic reactions... 

Dermatologic reactions (pruritus, erythema, urticaria, morbilliform)... 

Adverse Reactions Hypoglycemia Gastrointestinal disturbances (nausea, diarrhea, constipation, gastralgia) Dermatologic reactions (erythema, morbilliform or maculopapular eruptions, urticaria, pruritus, and eczema) Hematologic reactions (leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia, pancytopenia) Metabolic reactions (hepatic porphyria, disulfiram-like reactions) Hyponatremia Elevated liver enzymes... 

Gastrointestinal disturbances (nausea, vomiting, bloating, flatulence) Dermatologic reactions (rash/dermatitis)... 

Adverse Effects. When administered directly into the bladder, common side effects include bladder irritation and infection. Systemic administration (immunization) may also cause dermatologic reactions (peeling or scaling of the skin), allergic reactions, inflammation of lymph nodes, and local irritation or ulceration at the injection site. 

Dermal/Ocular Effects. Skin and eye irritations and dermatitis, but not sensitization, have been reported in humans and animals after dermal exposure of acute and intermediate-duration to both inorganic tin and organotin compounds. Mice also experienced a dermatological reaction to triphenyltin hydroxide after oral exposure over a period of 80 weeks. There is a reasonable probability of some skin, eye, and other mucous membrane contact with compounds at hazardous waste sites and the likelihood of irritation and other effects occurring. 

Dermatologic Reactions involving the skin are very common and may be severe in the elderly. 

Rare severe dermatologic reactions (Stevens Johnson syndrome)... 

Dermatologic reactions (especially with transdermai cionidine)... 

Hogan, D.J. Maibach, H.I. Adverse dermatologic reactions to transdermal drug delivery systems. J. Am. Acad. Dermatol. 1990, 22 (5 Pt 1), 811-814. 

---