Drug Rash: Causes and Symptoms

Causes of Drug Rash

Antibiotics, anti-seizure medications, and non-steroidal anti-inflammatory drugs (NSAIDs) can cause a variety of skin reactions.​ Warfarin, furosemide, and allopurinol can too.​ Skin reactions from medications range from mild rashes to severe, life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis.​ Reach out to your healthcare team if you develop a rash while taking medication.​

Antibiotics and Skin Reactions

Antibiotics are known to carry a risk of causing skin rashes and allergic reactions. Certain antibiotics like sulfa and penicillin antibiotics are common triggers for such reactions.​ For example, Bactrim (sulfamethoxazole/trimethoprim) belongs to sulfonamides group, which can lead to various skin reactions.​ Individuals with sulfa allergies are particularly susceptible to such medication-induced skin rashes.​

Common Medications Linked to Skin Reactions

Some of the common medications linked to skin reactions include antibiotics like sulfa and penicillin antibiotics.​ Sulfa antibiotics can trigger various skin reactions, especially in individuals with sulfa allergies.​ Additionally, medications such as Bactrim (sulfamethoxazole/trimethoprim) belonging to the sulfonamides group are known to cause a diverse array of skin reactions.​

Symptoms of Drug Rash

A drug rash is a skin breakout caused by a medication, often due to an allergic reaction. It can manifest as discoloration, bumps, itching, pain, blistering, hives, and swelling.​ The rash can vary from mild to life-threatening, requiring immediate medical attention. If you suspect a drug rash, consult a healthcare provider promptly for proper evaluation and management.​

Exanthematous Reactions

Exanthematous reactions typically begin as small bumps on the chest, stomach, or back and spread to the arms and legs.​ In light skin, the bumps appear red or pink, while in darker skin, they may look purple, brown, or skin-colored.​ This type of rash is the most common, accounting for almost 90% of all drug reactions involving the skin.​

Hives, Angioedema, and Anaphylaxis

Hives are itchy, raised patches on the skin, while angioedema involves swelling beneath the skin.​ In some cases, these reactions can progress to anaphylaxis, a severe and potentially life-threatening allergic reaction that affects multiple organ systems.​ Anaphylaxis can lead to breathing difficulties and shock.​ Prompt medical attention is crucial if these symptoms occur after taking medication.​

Fixed Drug Eruption

Fixed drug eruption typically presents as a single round skin patch that can be red, violet, or brown in color.​ This reaction may sometimes lead to blistering and can recur at the same spot on the body if the medication is restarted after cessation. Recognizing and promptly addressing fixed drug eruptions is crucial to prevent further complications.

Drug-Induced Vasculitis

Drug-induced vasculitis is characterized by inflammation of blood vessels, leading to leakage of blood into the skin.​ This results in the formation of tiny purple or brown spots that can progress into bumps or blisters.​ Although relatively rare, drug-induced vasculitis is a serious skin reaction that requires prompt medical attention to prevent complications.​

Rare but Life-Threatening Reactions

Some drug rashes, although rare, can be life-threatening.​ These reactions include drug rash with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and Serum sickness-like reaction.​ These severe reactions often involve widespread skin issues, organ damage, high fever, and can lead to serious complications if not promptly treated by healthcare professionals.