Erythematous rash

The word dermatitis denotes an inflammatory erythematous rash. The disorders discussed in this chapter include contact dermatitis, seborrheic dermatitis, diaper dermatitis, and atopic dermatitis. Drug-induced skin disorders have been associated with most commonly used medications and may present as maculopapular eruptions, fixed-drug eruptions, and photosensitivity reactions. 

Dermatologic Rash pruritus skin irritation increased pigmentation sweating/hyperhidrosis alopecia dry skin psoriasis acne eczema flushing purpura erythematous rash. 

Hematologic Agranulocytosis nonthrombocytopenic or thrombocytopenic purpura bleeding thrombocytopenia eosinophilia leukopenia hyperlipidemia. Hypersensitivity Pharyngitis photosensitivity reaction erythematous rash fever combined with aching and sore throat laryngospasm respiratory distress angioedema anaphylaxis. 

Dermafo/og/c. Alopecia, balanitis, erythema multiforme, erythema nodosum, fixed drug eruptions, hyperpigmentation of the nails, injection site erythema and injection site pain, maculopapular and erythematous rashes, photosensitivity, pruritus, skin and mucus membrane pigmentation, Stevens-Johnson syndrome, toxic epidermal necrolysis, vasculitis. 

Nitisinone is a reversibile inhibitor of 4-hydroxy-phenylpyruvate oxidase, an enzyme that plays a crucial role in the tyrosine catabolic pathway. Nitisinone prevents the accumulation of the toxic metabolites fumaryl acetoacetate, succinyl acetoacetate and succinyl acetone. Nitisinone is used for the treatment of hereditary tyrosinemia type 1. After oral administration bioavailability is 90% and peak levels are reached at 2.5 hours after dosing. The drug is eliminated mainly in the urine but some CYP3A4-mediated metabolism seems to occur. The elimination half-life is 45 hours. Blood dyscrasias are frequently occurring side effects as are eye problems like conjunctivitis, corneal opacity and keratitis. Exfoliative dermatitis, erythematous rash and pruritus... 

Systemic-. Diarrhea or constipation, vomiting, dizziness, erythematous rash, urticaria, reddish brown urine... 

Anorexia, nausea, vomiting, diarrhoea, glossitis, dysphagia, maculopapular and erythematous rashes and photosensitivity hypersensitivity reactions including urticaria, angioneurotic edema, anaphylaxis, anaphylactoid reactions. They also cause discoloration of deciduous teeth. 

In a multicenter, double-blind, randomized, fixed-dose trial of placebo and repaglinide 1 mg and 4 mg for 24 weeks in 361 patients there were no episodes of severe hypoglycemia (28). Most patients withdrew from the placebo group because of hyperglycemia, hypoglycemia, erythematous rash, headache, diarrhea, fatigue, or abnormal vision. Adverse effects had about the same frequencies in the two groups. 

A 69-year-old woman taking risperidone developed an erythematous rash with areas of blistering and early desquamation. It was most pronounced in exposed areas, although there was some spread beyond (189). 

Dermatologic Erythematous rash on face and upper body (red neck or red man syndrome - infusion rate related)... 

Similar serum enzyme elevations are found in polymyositis (A3, B4a, B20, D2, D17, E5, H7, KIO, M15, M18, Pl, P4, P5, P7, R15, S15, S26, T8, W12, W19), a nonspecific inflammatory myopathy sometimes associated with neoplastic disease but in general related to the collagen diseases and likewise responsive to corticosteroid therapy. The condition occurs at all ages in both sexes, may be acute or insidious with perhaps a normal erythrocyte sedimentation rate, may or may not be painful, or may be accompanied by an erythematous rash (dermatomyositis). Characteristically the earliest appearance of weakness is in the muscles of the pelvic... 

A 16-year-old girl with an 11-year history of frequent cold sores developed an erythematous rash and severe contact dermatitis during oral and topical aciclovir therapy (24). Patch tests showed contact sensitization to aciclovir and to the related compound ganciclovir. 

Anakinra is an interleukin-1 receptor antagonist. It has been used to treat rheumatoid arthritis (1,2). It has been tried in graft-versus-host disease, but without success (3). According to published trial data, moderate injection site reactions were the primary adverse effect and required treatment withdrawal in under 5% of patients. An erythematous rash was seldom observed. Although a few patients have developed antibodies to anakinra, these have not so far been associated with lack of efficacy or allergic skin reactions. 

A 67-year-old woman with pharyngitis gargled with Tantum verde, and after 3 weeks, during a holiday, developed an erythematous rash on sun-exposed skin, worsening within the next few days (8). She had not used a sunscreen. There were mainly well-demarcated areas of eczema on the face, neck, neckline, forearms, and lower legs. After oral and topical corticosteroids, the skin lesions improved within a few days. 

An erythematous rash with painful edema has been described with nifedipine (110) and also with dUtiazem, but without the edematous element (109). 

Grunwald Z. Painful edema, erythematous rash, and burning sensation due to nifedipine. Drug Intell Chn Pharm 1982 16(6) 492. 

A hypersensitivity reaction was confirmed by patch testing in a 73-year-old woman who had taken a single (unspecified) dose of a compound formulation containing pseudoephedrine (27). This caused the memorably named baboon syndrome, a widespread symmetrical erythematous rash with papules and pustules. 

A 50-year-old woman was given interferon alfa for chronic hepatitis C and primary biliary cirrhosis, and within 2 months became febrile and developed a diffuse nodular erythematous rash. The skin biopsy showed typical features of necrotizing angiitis, and cutaneous periarteritis nodosa was diagnosed. Full recovery was obtained after interferon alfa withdrawal and prednisolone treatment. 

Urticarial or erythematous rashes can occnr and persist for a few days. Rarely acnte vascnlitis, Stevens-Johnson syndrome, and bullous lichen planns have been reported (SEDA-11, 411) (SEDA-14, 422). 

A 50-year-old man with a history of severe asthma and tapering of prednisone took montelukast and developed an erythematous rash and mononeuritis multiplex skin biopsy confirmed the diagnosis of Churg-Strauss syndrome (10). 

A 62-year-old woman had a systemic contact dermatitis several days after topical administration of DoloPosterine ointment for hemorrhoids (33). She had erythematous vesicular lesions on her perianal area and an edematous erythematous rash on her upper thighs, elbow flexures, axillae, and face. Patch tests with the ointment and its constituents were positive with DoloPosterine and dibucaine 5% in petrolatum patch tests with benzocaine and other local anesthetics were negative. 

A 43-year-old white woman was given vancomycin for a suspected methicillin-resistant S. aureus infection (41). On day 10 she developed a fever, chills, and a disseminated lacy macular rash. Vancomycin was withdrawn but reinstituted 48 hours later. Another 24 hours later, she again developed a fever, chills, and a confluent erythematous rash. Sepsis developed, and ceftazidime was added. There was thrombocytopenia (118 x 10 /1), and a fall in the white blood count (from 7.6 to 3.5 X 10 /1) and hemoglobin (from 13.8 to 12.2 g/dl). One day later the leukocyte count was 2.6 x 10 /1 and the hemoglobin fell to 10 g/dl. Both drugs were withdrawn. The rash disappeared, the temperature returned to normal, and the blood cell counts completely recovered 4 days later. 

A 16-year-old girl who took yohimbine in the form of an alleged aphrodisiac known as yo-yo had an acute dissociative reaction accompanied by weakness, paresthesia, and incoordination, followed by anxiety, headache, nausea, palpitation, and chest pain she also had hypertension, tachycardia, tachypnea, sweating, pallor, tremor, and an erythematous rash (17). Serum adrenaline and noradrenaline concentrations were raised. Her symptoms lasted about 36 hours and resolved spontaneously. 

Skin distribution Extremities, hand and feet> trunk, face usually spared Face usually affected, hands and feet Face and neck usually affected Extremities Extremities, erythematous rash... 

HPI JJ is a 50-year-old woman with metastatic lung cancer, s/p frontal-temporal craniotomy for resection of a metastatic brain lesion 2 days ago. JJ is complaining of a pruritic, erythematous rash on her back and arms that she denies having prior to admission. PMH Metastatic lung cancer s/p chemotherapy and radiation therapy 6 months prior. Presented 3 weeks prior to admission with a new onset generalized tonic-clonic seizure. 

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