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Table 1 Symptoms of the acute phase of the reactions induced by drugs Modified from the NICE Clinical Guideline CG183 [59]

From: An EAACI task force report: recognising the potential of the primary care physician in the diagnosis and management of drug hypersensitivity

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