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Life-Threatening Drug-Induced Rashes

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1. Life-Threatening Drug-Induced Rashes

Life-Threatening Drug-Induced Rashes Life-Threatening Drug-Induced Rashes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Life (...) -Threatening Drug-Induced Rashes Life-Threatening Drug-Induced Rashes Aka: Life-Threatening Drug-Induced Rashes , Acute Life-threatening Hypersensitivity Skin Reaction From Related Chapters II. Causes: ABCDS Mnemonic See ( ) Non-follicular s at the flexor surfaces Within 4 days of beta lactam, or exposure Associated fever, and e insidious onset with s, beta-lactam antibiotics, s, , or ACE-Inhibitor induced ( ) Presentation similar to ( form rash) presentation, but >2 weeks after exposure Anticonvulsants

2018 FP Notebook

2. Assessment of rash in children

, ranging from self-limiting conditions (e.g., roseola) to life-threatening illnesses such as meningococcal disease. Several systemic conditions with a serious clinical course may have a rash as a component and should be assessed urgently if suspected (see Urgent considerations). Definitions Macule: a flat area of colour change <1 cm in size (e.g., viral exanthem [such as measles and rubella], morbilliform drug eruption). Patch: a large macule >1 cm in size (e.g., viral exanthem [such as measles (...) Assessment of rash in children Assessment of rash in children - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of rash in children Last reviewed: February 2019 Last updated: December 2018 Summary Childhood rashes are cutaneous eruptions of acute onset. Clinically, they may be categorised as maculopapular, pustular, vesiculobullous, diffuse/erythematous, or petechial/purpuric in nature. However, in many

2018 BMJ Best Practice

3. Assessment of rash in children

, ranging from self-limiting conditions (e.g., roseola) to life-threatening illnesses such as meningococcal disease. Several systemic conditions with a serious clinical course may have a rash as a component and should be assessed urgently if suspected (see Urgent considerations). Definitions Macule: a flat area of colour change <1 cm in size (e.g., viral exanthem [such as measles and rubella], morbilliform drug eruption). Patch: a large macule >1 cm in size (e.g., viral exanthem [such as measles (...) Assessment of rash in children Assessment of rash in children - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of rash in children Last reviewed: February 2019 Last updated: December 2018 Summary Childhood rashes are cutaneous eruptions of acute onset. Clinically, they may be categorised as maculopapular, pustular, vesiculobullous, diffuse/erythematous, or petechial/purpuric in nature. However, in many

2018 BMJ Best Practice

4. Life-Threatening Drug-Induced Rashes

Life-Threatening Drug-Induced Rashes Life-Threatening Drug-Induced Rashes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Life (...) -Threatening Drug-Induced Rashes Life-Threatening Drug-Induced Rashes Aka: Life-Threatening Drug-Induced Rashes , Acute Life-threatening Hypersensitivity Skin Reaction From Related Chapters II. Causes: ABCDS Mnemonic See ( ) Non-follicular s at the flexor surfaces Within 4 days of beta lactam, or exposure Associated fever, and e insidious onset with s, beta-lactam antibiotics, s, , or ACE-Inhibitor induced ( ) Presentation similar to ( form rash) presentation, but >2 weeks after exposure Anticonvulsants

2015 FP Notebook

5. Life-Threatening Accidental Intravenous Epinephrine Overdose in a 12-Year-Old Boy. (PubMed)

Life-Threatening Accidental Intravenous Epinephrine Overdose in a 12-Year-Old Boy. Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (...) an underrecognized event, which can result in potentially lethal complications. Heightening the awareness of the personnel, implementing safety precautions for the dosage and the route of administration, stocking of prefilled intramuscular dose syringes for emergency use in anaphylaxis and, ideally, introducing a standardized drug order form should reduce potential risks and facilitate proper and optimal treatment for all acutely ill children.

2018 Pediatric Emergency Care

6. Ketoconazole in Treating Participants With Ongoing EGFR Inhibitor-Induced Rash

Skin Burning Sensation Skin Rash Drug: Ketoconazole Other: Laboratory Biomarker Analysis Other: Placebo Other: Quality-of-Life Assessment Other: Questionnaire Administration Early Phase 1 Detailed Description: PRIMARY OBJECTIVES: I. To demonstrate that topical ketoconazole, an anti-androgen, palliates EGFR inhibitor-induced rash within a group of racially diverse cancer patients. II. To explore the role of ribonucleic acid (RNA) sequencing to identify other targets that might be used at a later (...) Ketoconazole in Treating Participants With Ongoing EGFR Inhibitor-Induced Rash Ketoconazole in Treating Participants With Ongoing EGFR Inhibitor-Induced Rash - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more

2018 Clinical Trials

7. A prospective, randomized, double-blinded, split-face/chest study of prophylactic topical dapsone 5% gel vs. moisturizer for the prevention of cetuximab-induced acneiform rash (PubMed)

prevention & control Facial Dermatoses chemically induced prevention & control Gels Humans Male Middle Aged Prospective Studies Quality of Life Skin Cream therapeutic use Thorax 2016 11 07 2017 03 07 2017 03 23 2017 8 16 6 0 2017 8 16 6 0 2017 9 19 6 0 ppublish 28807114 S0190-9622(17)30428-0 10.1016/j.jaad.2017.03.039 PMC5560517 NIHMS864928 Curr Med Res Opin. 2016 Nov;32(11):1839-1848 27398628 J Drugs Dermatol. 2010 Jun;9(6):667-71 20645528 J Am Acad Dermatol. 2001 Sep;45(3):420-34 11511841 Clin Exp (...) A prospective, randomized, double-blinded, split-face/chest study of prophylactic topical dapsone 5% gel vs. moisturizer for the prevention of cetuximab-induced acneiform rash 28807114 2017 09 18 2018 11 13 1097-6787 77 3 2017 09 Journal of the American Academy of Dermatology J. Am. Acad. Dermatol. A prospective, randomized, double-blinded, split-face/chest study of prophylactic topical dapsone 5% gel versus moisturizer for the prevention of cetuximab-induced acneiform rash. 577-579 S0190-9622

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2017 Journal of the American Academy of Dermatology

8. Preventive effect of kampo medicine (hangeshashin-to, TJ-14) plus minocycline against afatinib-induced diarrhea and skin rash in patients with non-small cell lung cancer (PubMed)

Preventive effect of kampo medicine (hangeshashin-to, TJ-14) plus minocycline against afatinib-induced diarrhea and skin rash in patients with non-small cell lung cancer Diarrhea and oral mucositis induced by afatinib can cause devastating quality of life issues for patients undergoing afatinib treatment. Several studies have shown that hangeshashin-to (TJ-14) might be useful for chemotherapy-induced diarrhea and oral mucositis. In this study, we investigated the prophylactic effects of TJ-14 (...) TJ-14 (7.5 g/day) and minocycline (100 mg/day) were administered simultaneously from the start of afatinib administration. The primary end point was the incidence of ≥ grade 3 (G3) diarrhea (increase of ≥7 stools/day over baseline) during the first 4 weeks of treatment. The secondary end points were the incidence of ≥ G3 oral mucositis (severe pain interfering with oral intake) and $ G3 skin toxicity (severe or medically significant but not immediately life-threatening).A total of 29 patients

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2017 OncoTargets and therapy

9. Doxycycline for prevention of erlotinib-induced rash in patients with non-small-cell lung cancer (NSCLC) after failure of first-line chemotherapy: A randomized, open-label trial. (PubMed)

Doxycycline for prevention of erlotinib-induced rash in patients with non-small-cell lung cancer (NSCLC) after failure of first-line chemotherapy: A randomized, open-label trial. Rash is a common epidermal growth factor receptor inhibitor-induced toxicity that can impair quality of life and treatment compliance.We sought to evaluate the efficacy of doxycycline in preventing erlotinib-induced rash (folliculitis) in patients with non-small-cell lung cancer.This open-label, randomized, prospective (...) , phase II trial was conducted in 147 patients with locally advanced or metastatic non-small-cell lung cancer progressing after first-line chemotherapy, randomized for 4 months with erlotinib alone 150 mg/d per os (control arm) or combined with doxycycline 100 mg/d (doxycycline arm). Incidence and severity of rash, compliance, survival, and safety were assessed.Baseline characteristics of the 147 patients were well balanced in the intent-to-treat population. Folliculitis occurred in 71% of patients

2016 Journal of the American Academy of Dermatology

10. Anticancer Drugs Induced Severe Adverse Cutaneous Drug Reactions: An Updated Review on the Risks Associated with Anticancer Targeted Therapy or Immunotherapies (PubMed)

Anticancer Drugs Induced Severe Adverse Cutaneous Drug Reactions: An Updated Review on the Risks Associated with Anticancer Targeted Therapy or Immunotherapies Cutaneous adverse drug reactions are commonly seen in patients with anticancer drug treatment. Anticancer drugs, including chemotherapy, target therapy, and recent immunotherapy causing skin reactions ranging from mild skin rash to life-threatening severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS (...) ) and toxic epidermal necrosis (TEN) with increase morbidity and mortality while they are receiving cancer treatments, have been proposed to be a result of direct skin toxicity or drug hypersensitivity reactions (these are proposed mechanism, not definite). Differentiating SCARs from other more commonly seen reactions with a better outcome help prevent discontinuation of therapy and inappropriate use of systemic immunosuppressants for presumable allergic reactions, of which will affect the clinical

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2018 Journal of immunology research

11. Rash Week! Briefs: Neonatal Mastitis

Rash Week! Briefs: Neonatal Mastitis Rash Week! Briefs: Neonatal Mastitis – PEMBlog Search for: Search for: Rash Week! Briefs: Neonatal Mastitis What is it? Neonatal mastitis is a localized cellulitis of the breast tissue. It may be accompanied by an abscess. Most cases are seen in infants <2 months of age. With the peak approximately 2 weeks of life (the peak age for abscess is a little older at 4 weeks). They are actually rarer in preemies, probably because the breast tissue has had less time (...) those under 2 months of age on IV antibiotics Clindamycin Nafcillin (if you do not suspect MRSA) Vancomycin Ill-appearing After obtaining urine and CSF studies you’ll want to treat with multiple drugs. options include: Vancomycin + nafcillin + ceftriaxone or cefotaxime Vancomycin + nafcillin + gentamicin Drainage of abscesses I&D is warranted if there is not spontaneous drainage. I will not drain a breast abscess, especially in a newborn female. You should always consult pediatric surgery/gynecology

2018 PEM Blog

12. Evaluation of the Safety and Performance of LiNiDERM® in the Prevention of Infant Diaper Rash

Posted: August 24, 2018 Last Verified: August 2018 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: No Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Laboratoires Gilbert: Infant diaper rash Baby wipes Oleocalcareous liniment Additional relevant MeSH terms: Layout table for MeSH terms Diaper Rash Dermatitis, Irritant Dermatitis, Contact Dermatitis Skin Diseases Skin (...) Evaluation of the Safety and Performance of LiNiDERM® in the Prevention of Infant Diaper Rash Evaluation of the Safety and Performance of LiNiDERM® in the Prevention of Infant Diaper Rash - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one

2018 Clinical Trials

13. Satisfaction and Quality of Life Comparison Between Patients Using Cicaplast Baume B5 Versus Dexeryl for the Management of Cutaneous Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors (iEGFR)

Satisfaction and Quality of Life Comparison Between Patients Using Cicaplast Baume B5 Versus Dexeryl for the Management of Cutaneous Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors (iEGFR) Satisfaction and Quality of Life Comparison Between Patients Using Cicaplast Baume B5 Versus Dexeryl for the Management of Cutaneous Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors (iEGFR) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers (...) : refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Satisfaction and Quality of Life Comparison Between Patients Using Cicaplast Baume B5 Versus Dexeryl for the Management of Cutaneous Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors (iEGFR) (CICAFIX) The safety and scientific

2018 Clinical Trials

14. Petechiae In Children (PIC) Study: Defining A Clinical Decision Rule for The Management Of Fever and Non-Blanching Rashes In Children Including The Role Of Point Of Care Testing For Procalcitonin & Neisseria Meningitidis DNA.

of a life-threatening infection known as meningococcal disease. The aim of the PIC study is to determine how best to diagnose early meningococcal disease in children. In particular the investigators are interested in researching how quick bedside tests can be used to do this. Condition or disease Meningitis, Meningococcal Meningococcal Sepsis Meningococcal Disease Meningococcal Infections Sepsis Meningitis Detailed Description: A fever an a non-blanching rash is a relatively common presentation (...) the the emergency department. A minority of children with a fever and a non-blanching rash with have a life-threatening infection. Currently it is very difficult to determine those children that require urgent treatment from those that have a simple viral illness. The aim of the PIC study is to research how to better diagnose those serious infections earlier. Data from the study will be used to test the effectiveness of current practice and to identify areas where current practice could be improved. Study

2017 Clinical Trials

15. A rash decision. The hazards of the wrongful use of adrenaline (PubMed)

A rash decision. The hazards of the wrongful use of adrenaline Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (ACEI) presented to the emergency department with non-pitting oedema of the face and limbs. A hasty diagnosis of anaphylaxis was made (...) and intravenous adrenaline administered. The patient developed a myocardial infarction caused by coronary artery spasm that required invasive intervention. The initial clinical picture was resolved when the ACEI was discontinued unmasking a case of ACEI-induced angioedema. The correct differentiation of these two apparently similar clinical entities is of utmost importance in the management of emergency department patients.

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2017 Romanian Journal of Anaesthesia and Intensive Care

16. Association Between HLA-B*1301 and Dapsone-Induced Cutaneous Adverse Drug Reactions: A Systematic Review and Meta-analysis. (PubMed)

Association Between HLA-B*1301 and Dapsone-Induced Cutaneous Adverse Drug Reactions: A Systematic Review and Meta-analysis. Dapsone-induced hypersensitivity syndrome (DHS) is a life-threatening adverse drug reaction. Based on available epidemiologic studies, HLA genotypes may play an important role in DHS.To assess the association between HLA-B*1301 and dapsone-induced cutaneous adverse drug reactions (cADRs).Human studies investigating associations between HLA-B*1301 and dapsone-induced cADRs (...) missing from the meta-analysis; 1 each from 2 of the 3 studies); mean age was 39.7 years. An association between HLA-B*1301 and dapsone-induced cADRs was identified (summary OR, 43.0; 95% CI, 24.0-77.2). Subgroup analyses among types of cADRs produced similar findings in DHS (OR, 51.7; 95% CI, 16.9-158.5), dapsone-induced severe cADRs (Stevens-Johnson syndrome and toxic epidermal necrolysis [SJS/TEN] plus drug rash [adverse skin reaction to a drug] along with eosinophilia and systemic symptoms [DRESS

2018 JAMA dermatology (Chicago, Ill.)

17. Drug-Induced Hypersensitivity Syndrome: A Clinical, Radiologic, and Histologic Mimic of Lymphoma (PubMed)

Drug-Induced Hypersensitivity Syndrome: A Clinical, Radiologic, and Histologic Mimic of Lymphoma Drug-induced hypersensitivity syndrome (DIHS; also known as drug reaction with eosinophilia and systemic symptoms, or DRESS) is a rare, potentially life-threatening condition that typically presents 2-8 weeks after drug exposure with fever, rash, organ dysfunction, and lymphadenopathy. Here, we describe the case of an 18-year-old African American female who presented with cervical lymphadenopathy (...) , fevers, and a macular rash. A PET scan showed diffuse hypermetabolic lymphadenopathy suggestive of lymphoma, with involvement of the spleen and kidneys. The clinical history, imaging, and biopsy findings initially raised concern for a malignant process, with a differential diagnosis including classic Hodgkin's lymphoma and T-cell lymphoma. However, the morphologic and immunophenotypic features were not entirely typical for those diagnoses. The patient was ultimately diagnosed with DIHS after

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2018 Case reports in hematology

18. Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life

of short-term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long-term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional (...) for starting antiretroviral therapy (ART) have changed as continuing improvements in treatment mean that the objectives of ART should increasingly be optimizing health status for a full and productive adult life rather than just survival. • New drugs have been incorporated into the guideline as ?rst- and second-line options. The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines have been updated from those of 2009 [1], and make recommendations based on a shift in aims of treatment

2018 The Children's HIV Association

19. Antiretroviral / HIV Drug Dosing for Paediatrics

Inhibitors (NNRTI): Require TDM with Rifamycins. Long half-life consider cover with PI after stopping Nevirapine (NVP) Child lead in period for 14 days: (3-5.9kg)? 50mg OD, (6-9.9kg)? 80mg OD, (10-13.9kg)? 100mg OD, (14-19.9kg)? 130mg OD, (20-24.9kg)? 150mg OD, then if no rash or LFT abnormalities after 14 days see maintenance dose below. Child maintenance dose: (3-5.9kg)? 50mg BD, (6-9.9kg)? 80mg BD, (10-13.9kg)? 100mg BD, (14-19.9kg)? 130mg BD, (20-24.9kg)? 150mg BD. Total daily dose may be given as OD (...) can be cut. Higher EFV levels in CYP2B6-TT Genotype Take on empty stomach preferably before bedtime. High fat meal can ? EFV AUC by 30% and ? adverse reactions Mood changes, vivid dreams (common but usually short lived), hypercholesterolemia, rash, gynaecomastia Protease Inhibitors (PI): Lipodystrophy, hyperlipidaemia, diabetes mellitus, important interactions with a range of other drugs: consider TDM Lopinavir/ritonavir (LPV/RTV) All doses based on lopinavir ***PLEASE SPECIFY FORMULATION WHEN

2018 The Children's HIV Association

20. Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents. (PubMed)

within paediatric pain management. Non-steroidal anti-inflammatory drugs are currently licensed for use in Western countries, however they are not approved for infants under three months old. The main adverse effects include renal impairment and gastrointestinal issues. Common side effects in children include diarrhoea, headache, nausea, constipation, rash, dizziness, and abdominal pain.To assess the analgesic efficacy and adverse events of NSAIDs used to treat chronic non-cancer pain in children (...) Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents. Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed

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2017 Cochrane

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