Pediatric drug eruptions

• Published in: Clinics in dermatology Vol. 38; no. 6; pp. 629 - 640
• Main Authors: Nguyen, EmilyD, Gabel, Colleen K., Yu, JiaDe
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2020
• Subjects: Adolescent; Child; Child, Preschool; Drug Eruptions - diagnosis; Drug Eruptions - etiology; Drug Eruptions - pathology; Drug Eruptions - therapy; Drug Hypersensitivity Syndrome; Female; Humans; Infant; Male; Quality of Life; Serum Sickness; Skin - pathology; Urticaria; Withholding Treatment
• ISSN: 0738-081X; 1879-1131
• DOI: 10.1016/j.clindermatol.2020.06.014

Drug eruptions in children are common but in general less studied than their adult counterparts. Aside from having significant impact on the child’s health and quality of life, these reactions can limit what medications the patient can receive in the future. Familiarity with pediatric drug eruptions is important for accurate diagnosis and to prevent future recurrence or ineffective therapy. Our current understanding of how drug reactions differ mechanistically between children and adults is poor. There are multiple factors that could be contributing to the differing incidence, presentation, and treatment modalities offered to pediatric versus adult patients. For many of these cutaneous drug reactions, the treatment regime is not standardized, being based primarily on case reports. Although not comprehensive, this review highlights common pediatric drug eruption patterns and discuss diagnostic mimickers. Five cutaneous adverse drug reactions in the pediatric population are presented: morbilliform (exanthematous) eruptions, urticarial eruptions, serum sickness–like reactions, fixed drug eruptions, and DRESS syndrome. Clinical features, diagnostic workup, and management are discussed with an emphasis on the pediatric population.