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Cutaneous adverse drug reactions (CADR), also known as toxidermia, are skin manifestations resulting from systemic drug administration. These reactions range from mild erythematous skin lesions to much more severe reactions such as Lyell's syndrome. They represent a heterogeneous field, including various clinical patterns without specific features suggesting drug causality. This activity describes the evaluation and management of cutaneous adverse drug reactions and explains the role of the interprofessional team in managing patients with this condition. Objectives: Describe the range of skin manifestations of cutaneous adverse drug reactions. Explain the pathophysiology of cutaneous adverse drug reactions. Outline the most common causes of a cutaneous adverse drug reaction. Review the importance of the interprofessional team working together to find the underlying explanation for a cutaneous adverse drug reaction to improve outcomes. Access free multiple choice questions on this topic.

Cutaneous adverse drug reactions (CADR), also known as toxidermia, are skin manifestations resulting from systemic drug administration. These reactions range from mild erythematous skin lesions to much more severe reactions such as Lyell's syndrome. They represent a heterogeneous group, including various clinical patterns without specific features that suggest drug causality. It is essential to search for the causative agent.[1][2]

Each year, thousands of people develop adverse drug reactions (ADR), with a minority resulting in fatalities. Skin reactions are the most common type of ADR and can be diagnostically challenging. Healthcare workers, including nurses and pharmacists, must be vigilant about ADR as they can present at any time in any patient and have a wide range of presentations. The skin reactions can confound even the most experienced specialist. Polypharmacy, or the use of multiple medications, can make the determination of the offending agent even more difficult. Furthermore, there are genetic variations linked to skin reactions, often associated with antiepileptic medications. It is important for healthcare workers to understand that FDA approval does not ensure safety for every patient. During the FDA approval process, the drug is usually studied in a small number of people for a short time, and hence, many side effects can be missed. These trials do not always determine the rare side effects of drugs, and often, the ADRs are picked up during post-marketing surveillance. Drugs can be FDA-approved and enter the market after phase 3 clinical trials, which are typically conducted before long-term effects are well documented. Thus, it is essential for the healthcare team to be vigilant about ADRs and to monitor patients closely.[14][15]