Toxic erythema

The skin may respond adversely in a number of different ways; toxic erythema describes the most common morbilliform presentations where there are symmetrical erythematous macules and papules, larger more confluent patches or urticated plaques. These initial presentations may progress into a more severe picture, e.g. drug hypersensitivity syndrome (DHS) (see later) or toxic epidermal necrolysis. Patients with a suppressed immune system, for example those who have the human immunodeficiency virus (HIV), are more susceptible to drug reactions of this type (Box 13.4).

Box 13.4 Categories of drugs that can cause toxic erythema   Antibiotics Barbituates   Antihypertensives Hydantoins   Non-steroidal antiinflammatories