Clinical
Manifestations
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- Patients show a history of medication.
- There is an incubation period of 20-40 days.
- If the medication is taken frequently, the incubation period shortens to as little as two hours.
- The shape of the rash is varied.
- The color is bright.
- The involved area is vast and often symmetric.
- Itching
- Burning Heat
- Usually accompanied by general symptoms.
- The course is usually short if the patient ceases the dermatitis-inducing drug or receives proper treatment.
- Urticaria-like type:
Urticaria of various sizes over large areas
Redder than common urticaria
Itching with stabbing pain and tenderness
- Scarlet fever or measle-like type:
Extensive bright red macular , papular and
maculopapular eruptions
They can be millet to soy bean sized and spread over the skin symmetrically
Itching
No general symptoms (this is the main differentiation between measles or scarlet fever)
- Erythema multiform-like type:
The rash is in the form of edematous purple maculae
The size ranges from a soybean to a coin
The center is darker with possible vesicles
It occurs symmetrically on the torso and limbs
It sometimes
involves the mouth, lips, eyes and pudendum
Erosion
Exudation
Itching
Fever
Arthralgia
Abdominal pain
- Fixed erythematous type:
This is a very common type
Edematous, bright red, or purple, round or oval shaped maculae
The center may have some vesicles
Affects the eyes, anus, glans penis, and areas around the mouth where mucous membranes meet
May be found on the torso and limbs
Generally disappears within ten days unless there is ulceration on the pudendum
Itching
Long-lasting pigmentation will be left after recovery
When the same drug is taken, the rash will appear in the same places
- Purpuric type:
Various sized echymoses or petechiae
It feels flat or slightly raised
In mild cases it is mostly on the legs
In severe cases, it can involve the whole body
- Exfoliative dermatitis type:
This is severe with an incubation period of over twenty days
The onset is often abrupt
Measle-like and papular eruptions appear first then merge into a general diffuse rash
The hands and feet may have edema and erosion, followed by repeated scaling and possibly by exfoliation of the hair and nails
General itching and burning
Aversion to Cold
Nausea and vomiting
Generally lasts over a month
- Epidermolytic, big-vesicle-like type:
This is the most severe type
The onset is abrupt
Continuous fever
Bright red or purple maculae soon covering the whole body
The lesions the take on folds, followed by loose purple vesicles, which are liable to ulcerate
If there is concurrent infection, hematosepsis often results
It is usually followed by exfoliation of mucous membranes of the mouth, trachea and esophagus with Spleen and Liver damage
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