Epidemiology

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Etiology

• Common triggers
  • Antiepileptics: lamotrigine, phenytoin, carbamazepine
  • dapsone, sulfamethoxazole/trimethoprim; vancomycin, minocycline; sulfonamides
  • allopurinol

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Pathophysiology

Delayed hypersensitivity reaction (type IV HSR) to drug metabolites

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Clinical features

• Systemic symptom
  • Fever, typically high (> 38.5°C/101.3°F) and spiking
• Diffuse rash
  • Typical manifestation: generalized morbilliform pruritic rash
    • The term morbilliform refers to a rash that looks like measles.
• Signs of internal organ involvement
  • Multiorgan failure

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Diagnostics

Eosinophilia, thrombocytopenia, atypical lymphocytes often present

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Treatment

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