Drug-induced toxicoderma

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Drug-induced toxicoderma encompasses skin diseases that can affect the skin, mucous membranes, hair, nails, sweat glands, etc.

Any medication can cause it. The most frequent are some antibiotics, anti-epileptics and non-steroidal analgesics/anti-inflammatory drugs.

It manifests itself in a variety of ways, causing reddish patches that can coalesce to form large red areas, welts, scaling and/or itching of the skin.

Diagnosis is made on the basis of a complete medical history and physical examination.

The first thing to do to treat toxicoderma is to withdraw all questionable drugs. If the reaction produced by the drug is mild, the treatment used is symptomatic, including taking antihistamines and in some cases corticosteroids, topically or orally. If the reaction is severe, hospital admission to the intensive care unit or burns unit, fluid replacement and use of antimicrobials are necessary.

Bibliographic references
  1. Andrew D Samel, MD, Chia-Yu Chu, MD, PhD. Drug eruptions. UpToDate. Oct 03, 2016.
  2. Loricera J, Blanco R, Ortiz-Sanjuán F, et al. Single-organ cutaneous small-vessel vasculitis according to the 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides: a study of 60 patients from a series of 766 cutaneous vasculitis cases. Rheumatology (Oxford) 2015; 54:77.
  3. Simons FE, Ardusso LR, Dimov V, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol 2013; 162:193.
  4. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65:1.
  5. Shinkai K, Stern R, Wintroub B. Reacciones farmacológicas cutáneas. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición. 377:390.
Author
Dr. Elvira Moreno
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© TeckelMedical 2026

Symptoms

    Red rash after medication intake


    Skin spots remain even upon applying pressure on them


    Skin irritation with flaking patches


    Welts/wheals on the skin


    Both eyes red

Symptoms to watch out for

The lesions spread throughout all the body
Fever (temperature higher than 38 ºC)
If symptoms affect the quality of life
Pregnancy
History of immunodeficiency (HIV, diabetes mellitus, oncological disorders, long-term corticosteroid consumption).

Self-care

Discontinue recently initiated medication.
Consume antihistamines against itching.