Cutaneous Manifestations of Adverse Drug Reactions

immune-mediated cutaneous reactions to drugs are usually categorized into four distinct types: Type 1, immediate; Type 11, cytotoxic; Type III, immune-complex: and Type IV, cell-mediated. Nonimmunologic skin reactions are also recognized. Beyond immune vnonimmune classifications, cutaneous drug reactions are generally described according to morphologic patterns of reaction. Common types of reactivity usually include maculopapular and urticarial eruptions. In addition, less common reactions include fixed drug eruption, hyperpigmentation, vasculitis, erythema multiforme, toxic epidermal necrolysis, photosensitivity, and alopecia. The drugs most frequently associated with these reactions can be identified and the pharmacist, by accomplishing a thorough systematic drug history, may play a significant role in determining likelihood of drug cause.