Table 1 Symptoms of the acute phase of the reactions induced by drugs Modified from the NICE Clinical Guideline CG183 [59]
Type of reaction | Clinical entity | Symptoms |
|---|---|---|
Immediate: onset usually < 1 h after drug exposure (previous exposure not always confirmed) | Anaphylaxis | Erythema, urticaria or angioedema and Hypotension and/or bronchospasm |
Urticaria or angioedema without systemic features | Wheals Angioedema | |
Exacerbation of asthma | Dyspnea Cough Chest tightness Wheezing | |
Non-immediate without systemic involvement: onset usually 6–10 days after first drug exposure or within 3 days of second exposure | Exanthema-like | Widespread red macules or papules |
Fixed drug eruption | Single or multiple erythematous plaques that arise at the same site after the intake of the same drug and that resolve leaving post-inflammatory hyperpigmentation | |
Non-immediate reactions with systemic involvement: onset usually 2–6 weeks after first drug exposure or within 3 days of second exposure. | Drug reaction with eosinophilia and systemic symptoms (DRESS) or drug hypersensitivity syndrome (DHS) | Widespread red macules, papules or erythroderma Fever Lymphadenopathy Liver dysfunction Eosinophilia |
Toxic epidermal necrolysis or Stevens–Johnson syndrome | Painful rash and fever Mucosal or cutaneous erosions Vesicles, blistering or epidermal detachment Red purpuric macules or erythema multiforme | |
Acute generalized exanthematous pustulosis (AGEP) | Widespread pustules Fever Neutrophilia | |
Other common disorders rarely caused by drug allergy | Eczema Hepatitis Nephritis Photosensitivity Vasculitis |