Published online October 1, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e1082-e1096 (doi:10.1542/peds.2005-2321)
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REVIEW ARTICLE

Cutaneous Reactions to Drugs in Children

Alissa R. Segal, PharmD, PhCa, Kevin M. Doherty, PharmDb, John Leggott, MDc and Barrett Zlotoff, MDd

a Department of Pharmacy Practice, Massachusetts College of Pharmacy & Health Sciences, Boston, Massachusetts
b Texoma Medical Center, Denison, Texas
c Department of Family and Community Medicine, School-Based Health Centers
d Department of Dermatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico

Cutaneous eruptions are a commonly reported adverse drug reaction. Cutaneous adverse drug reactions in the pediatric population have a significant impact on patients' current and future care options. A patient's recollection of having a "rash" when they took a medication as a child is a frequent reason for not prescribing a particular treatment. The quick detection and treatment of cutaneous adverse drug reactions, plus identification of the causative agent, are essential for preventing the progression of the reaction, preventing additional exposures, and ensuring the appropriate use of medications for both the current condition and others as the patient ages. The purpose of this review is to discuss a reasonable approach to recognition and initial management of cutaneous adverse drug reactions in children.

Key Words: adverse drug reactions • children • dermatology • cutaneous reactions

Abbreviations: CADR—cutaneous adverse drug reaction • ADR—adverse drug reaction • FDA—Food and Drug Administration • ECE—exanthematous cutaneous eruption • EM—erythema multiforme • FDE—fixed drug eruption • NSAID—nonsteroidal antiinflammatory drug • SSLR—serum sickness–like reaction • DHS—drug hypersensitivity syndrome • SJS—Stevens-Johnson syndrome • TEN—toxic epidermal necrolysis

Accepted Mar 3, 2007.