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Morphological Classification of Drug Eruptions

  1. Acanthosis Nigricans-Like Eruption
    Corticosteroids, Hydantoin, Nicotinic Acid, Pills, Stilbestrol
  2. Acneiform Eruption
    Anticonvulsant (phenytoin, phenobarbital, trimethadione), Antituberculous (isoniazid, ethionamide, rifampicin), Corticosteroids, Corticotropin (ACTH),  Halogens (bromides, chlorides, iodides, halothane)
  3. Acral Erythema/Red Palms
    Adriamycin (Doxorubicin), Cytosine arabinoside, 5-fluorouracil
  4. Acrodynia
    Mercury
  5. Alopecia
    Allopurinol, Bromocriptine, Carbimazole, Chlorambucil, Chloramphenicol, Cholesterol lowering agents, Cimetidine, Colchicine, Coumarin, Cytotoxic drugs, Diazoxide, Ethionamide, Fluconazole, Gentamicin, Gold, Heavy metals, Heparin, Hydantoin, Levodopa, Methotrexate, Methyldopa, NSAID (indomethacin, piroxicam), Pills, Phenindione, Propranolol, Sodium valproate, Thiouracil, Vitamin A or Retinoids.
  6. Anaphylactic Reaction
    Acetylsalicylic acid, ACTH, Aminopyrine, Meprobamate, Mercurial Diuretics, Para-aminosalicylic Acid, Penicillin, Pituitary Extract, Procaine, Succinylcholine, Tetracycline, Thiouracil.
  7. Angiitis, Necrotizing
    Bishydroxycoumarin (Dicumarol)
  8. Angioedema
    Meprobamate, Penicillin, Stilbestrol, Sulfonamides
  9.  Argyria
    Silver Salts
  10.  Arteritis
    Cyclobarbital, Chlorpromazine, Iodides, Phenylbutazone, Phenytoin, Poison Ivy Extract, Sulfonamides, Thiouracil.
  11. Black Hairy Tongue Tetracycline, Penicillin Bowen's Disease
    Arsenic, Fowler's Solution
  12. Bullous Eruption
    Acetylsalicylic acid, Antipyrines, Arsenic, Barbiturates, Bromide, Chloral hydrate, Chlorpromazine, Coumarin, Dilantin, Glutethimide, Hydantoin derivatives, Ibuprofen, Imipramine, Iodide, Phenobarbital, Phenylbutazone, Promethazine, Methadone, Meprobamate, Nitrazepam, Sulfonamides.
  13. Candidiasis: Tetracyclines
  14. Chilblains-Like Erythema: Coumarins, Phenindione, Sulindac
  15. Cyanosis: Acetanilide
  16. Depigmentation: Chloroquine
  17. Eczematous Reactions (other than contact eczema)
    Aminophylline, Antibiotics, Antihistamine, B-blockers, Benzocaine, Bleomycin, Carbamazepine, Chloral Hydrate, Diphenhydramine, Disulfuram, Fluorouracil, Fucidin, Meprobamate, Methaminodiazepoxide, Minoxidil, Neomycin, Nystatin, Phenothiazines, Procainamide, Procaine, Quinacrine, Quinidine, Resorcin, Streptomycin (cross-reaction with neomycin), Sulphonamide, Thiazide.
  18. Edema
    Arsenic, Chlorpromazine, Penicillin, Phenytoin, Promethazine, Chloroquine.
  19. Elastosis Perforans Serpiginosa
    Penicillamine
  20. Erythema/Exanthem
    Allopurinol, Ampicillin, Antipyrines, Arsenic, Atropine, Aurothioglucose, Barbiturates, Carbamazepine, Chloral hydrate, Chlorpropamide, Codeine, Corticotropin, Gentamicin, Gold, Griseofulvin, INH, Interleukin-2, Meprobamate, Methaminodiazepoxide, Morphine, Nicotinic Acid, Nitrofurantoin, Opium, Penicillin, Phenothiazine, Phenylbutazone, Pilocarpine, Quinacrine, Quinidine, Quinine, Streptomycin, Sulphonamides, Sulphamethoxypyridazine, Thiazide, Thiamine Chloride, Tolbutamide.
    1. Maculopapular rash
      Allopurinol, Chloroquine, Meprobamate, Penicillin, Promethazine, Streptomycin, Sulfamethoxypyridazine
    2. Morbilliform erythema
      Acetylsalicylic acid, Ampicillin, Barbiturates, Bromides, Chlorpromazine, Griseofulvin, Insulin, Meprobamate, Penicillin, Promethazine, Salicylates, Streptomycin
    3. Scarlatiniform erythema
      Barbiturates, Mercury, Morphine, Opium, Penicillin, Phenobarbital, Pituitary Extract, Quinine, Salicylates, Streptomycin, Sulfonamides
    4. Toxic erythema
      1. Drugs most commonly responsible (up to 5% of patients affected):
      2. Allopurinol, Carbamazepine, Cephalosporins, Gold, Nalidixic acid, Penicillins, Sulphonamides
      3. Other drugs commonly responsible (1-4% of patients affected):
      4. Isoniazid, Para-amino salicylic acid, Phenytoin, NSAIDs, Nitrofurantoin, Streptomycin
  21. Erythema Multiforme (including Stevens-Johnson syndrome and toxic epidermal necrolysis)
    Acetylsalicylic acid, Allopurinol, Amidopyrine, Antihistaminics, Anti-pyrines, Barbiturates, Bromides, Carbamazepine, Chloral hydrate, Cimetadine, Corticotropin (ACTH), Furosemide, Griseofulvin, Hydantoins, Iodides, Mercury, NSAIDs (especially piroxicam), Para-aminosalicyclic Acid, Penicillins, Phenytoin, Phenolphthalein, Phenothiazine, Phenyl-butazone, Procaine, Streptomycin, Sulfamethoxy-pyridazine, Sulphonamides, Tetracycline.
  22. Erythema Nodosum
    Acetylsalicylic Acid, Bromides, Gold, Iodides, Penicillin, Phenacetin, Pills, 13-cis-retinoic acid, Salicylates, Sulfathiazole, Tetracycline.
  23. Erythroderma (Exfoliative Dermatitis)
    Allopurinol, Aminosalicylic Acid, Arsenicals, Aurothioglucose, Barbiturates, Bismuth, Captopril, Carbamazepine, Cefoxitin, Chlorpromazine, Chloroquine, Cimetadine, Dapsone, Diltiazem, Gold, Griseofulvin, Hydantoin, Iodides, Isoniazid, Lithium, Mercury, Nitrofurantoin, NSAID, Penicillin, Phenothiazines, Phenytoin, Quinidine, Quinacrine, Sodium Thiosulfate, Stilbestrol, Streptomycin, Sulphamethoxypyridazine, Sulphonamides, Sulphonylurea, Tetracycline, Thiouracil, Retinoid.
  24. Erythromelalgia
    Bromocriptine, Nifedipine, Pergolide, Verapamil
  25. Fixed Drug Eruption
    Aminopyrine, Amphetamines, Antihistaminics, Antimony Compounds, Antipyrines, Arsenic, Barbiturates, Bismuth, Chlordiazepoxide, Chloral Hydrate, Chloroquine, Codeine, Dapsone, Gold, Diethylstilbestrol, Digitalis, Ephedrine, Ergot, Hydantoin, Hydralazine, Iodides, Meprobamate, Mercury, Metronidazole, Morphine, NSAIDs, Opium, Para-aminosalcylic acid, Paracetamol, Penicillin, Phenacetin, Phenolphthalein, Phenothiazine, Phenylbutazone, Potassium Chlorate, Quinacrine, Quinine, Reserpine, Salicylates, Streptomycin, Sulfonamides, Sulindac, Tetracyclines, Tetraiodofluorescein.
  26. Gangrene
    Coumarin
  27. Gingival Hyperplasia
    Cyclosporin, Nifedipine, Hydantoin
  28. Hair Color Changes
    Carbamate, Chloroquine, Chlorpromazine
  29. Henoch-Shonlein Purpura-Like Eruption
    Diltiazem, Frusemide
  30. Hirsutism/Hypertrichosis
    Acetazolamide, Anabolic agents, Bromocryptine, Chlorobenzene, Corticosteroid, Cyclosporin, Cyproterone, Danazol, Diazoxide, Digoxin, Diphenylhydantoin, Dyazide, Metyrapone, Minoxidil, Penicillamine, Phenothiazine, Progestogens, Psoralens, Spironolacton, Streptomycin
  31. Ichthyosis, Acquired
    Butyrophenone, Nicotinic acid, Triparanol.
  32. Jaundice
    Aurothioglucose, Erythromycin lauryl sulphate, Para-aminosalicylic Acid, Phenobarbital, Thiouracil.
  33. Keratoderma: Gold
  34. Keratoses: Arsenic, Fowler's Solution, Gold.
  35. Le-Like Syndrome
    Acebutolol, Allopurinol, Aminoglutethimide, Aminosalicylic acid, Captopril, Carbamazepine, Chlorpromazine, Cimetidine, Ethosuximide, Gold, Griseofulvin, Hydantoin, Hydralazine, Isoniazid, Labetolol, Lithium, Mephobarbital, Methyldopa, Minocycline, Penicillin, Phenylbutazone, Phenytoin, Pill, Practolol, Procainamide, Reserpine, Streptomycin, Sulfamethoxypyridazine, Sulphonamide, Tetracycline HCI (degraded), Thiazide, Thionamide, Thiouracil.
  36. Lichenoid Eruption
    Beta-blocker (Practolol), Bismuth, Captopril, Carbamazepine, Chloroquine, Cholorpropamide, Gold, Hydroxyurea, Meprobamate, Mepacrine, Methyldopa, para-amino-salicyclic acid, Penicillamine, Phenothiazine, Quinine, Quinidine, Streptomycin, Sulphonylurea, Tetracycline, Thiazides.
  37. Linear Ig-A Dermatosis
    Amiodarone, Captopril, Cefamandole, Diclophenac, Lithium, Vancomycin.
  38. Livedo Reticularis: Amantadine
  39. Lymphoproliferative Disease/Pseudolymphoma
    ACE-inhibitor, Carbamazepine, Cyclosporin, Dantrolene, Diltiazem, Hydantoin, Pyrazolone, Pyrimethamine.
  40. Mucosal Ulcerations, Oral: Foscarnet, DDC, Interferon.
  41. Nail Changes
    Amodiaquin (hyperpigmentation), arsenic (longitudinal white stripes), argyria (dark blue nail bed), Chloroquine (blue-black nail bed), Phenolphthalein (dark blue fixed eruption), tetracycline (yellow nail and yellow fluorescence), demethylchlortetracycline (phototoxic onychomadesis).
  42. Ochronosis-Like Pigmentation: Phenol, Quinacrine, Resorcin.
  43. Onycholysis: Demethylchlortetracycline.
  44. Papular Dermatitis
    Acetazolamide, Acetylsalicylic acid, Arsenic, Aurothioglucose, Digitalis, Penicillin, Thiazide.
  45. Pellagra-Like Eruption: Isoniazide
  46. Pemphigoid-Like Eruption
    1. Bullous
       
      5-Fluorouracil (topical), Frusemide, Ibuprofen, Penicillamine, Penicillin, Sulphasalazine, PUVA.
    2. Cicatrical
       
      Anti-glaucoma agent (topical), Clonidine, Indomethacin, D-penicillamine, Practolol, Sulphadoxine.
  47. Pemphigus-Like Eruption
    Ampicillin, Captopril, Enalapril, Pencillamine, Penicillin, Phenylbutazone, Pyrazolan derivative, Rifampicin, Sulphydryl groups (pyritinol, thiopronin).
  48.  Photosensitivity
    Amiodarone, Chlorthiazide, Chlorpromazine, Chlorpropamide, Cytotoxic (Dacarazine, Methotrexate, Fenofibrate, Fluorescein, 5-fluorouracil, Furocoumarins, Griseofulvin, Nalidixic acid, NSAID (benoxaprofen, piroxicam, naproxen), Phenothiazine, Promethazine, Psoralen (Methoxsalen, Trimethylpsoralen), Quinidine, Quinine, Quinolones, Reserpine, Retinoids, Sulphonamides, Sulphonylureas, Sunscreen (PABA, oxybenzone), Tetracyclines (demeclotetracycline, doxycycline, tetracycline), Tolbutamide, Tricyclic antidepressant (Clomipramine, Carbamazepine).
  49. Pigmentation
    Amiodarone (slatey grey pigmentation on light-exposed skin)
    Antimalarials (diffuse generalized grey/brown pigmentation; mepacrine causes generalized
    yellow/orange discoloration resembling jaundice

    Antipyrines, Bismuth (gums)
    Clofazimine

    Chlorpromazine (slate-colored)
    Chloroquine (bleaching of hair)

    Cytotoxic drugs (busulphan, bleomycin, cyclophosphamide, fluorouracil, hydroxyurea, may cause generalized brown pigmentation)
    Gold/silver (chrysiasis) blue/grey pigmentation on light-exposed skin)

    Minocycline hydrochloride (blue/grey pigmentation on light-exposed skin and in scars)
    Oral contraceptives (melasma -brownish pigmentation on face)

    Phenformin (brown pigmentation on light-exposed skin)
    Phenothiazines (bluish pigmentation on light-exposed skin, especially on the face)

    Phenytoin (melasma-like pigmentation on face)
    Streptomycin, Tetracosactide, Tetracyclines, Thiouracil

    Zidovudine (AZT) (melanonychia, diffuse cutaneous/oral mucosal pigmentation, acral hyperpigmented macules)
  50. Pityriaisis Rosea-Like Eruption
    Arsenicals, Bismuth, Gold, Barbiturates, Clonidine, Captopril, Isotretinoin, Ketotifen, Methoxypromazine, Metronidazole, Pyribenzamine
  51. Polyarteritis Nodosa-Like Eruption
    Sulfonamides, Thiouracil, Iodides
  52. Porphyria
    (Drugs provoke variegate porphyria):
    Alcohol, Androgens, Barbiturates, Carbamazepine, Chlordiazepoxide, Chloroquine, Griseofulvin, Hexachlorobenzene, Hydantoin, Meprobamate, Nortriptyline, Pills, Oestrogens, Sodium valproate, Sulphonamides, Sulphonylureas
    (Drugs provoke porphyria cutanea tarda):

    above + Busulphan, Quinidine, Quinine, Rifampicin
  53. Pseudo-Porphyria
    Amiodarone, Bumetamide, Ciprofloxacin, Frusemide, Nalidixic aid, NSAID, Ofloxacin, Tetracycline.
  54. Pruritus
    Alkaloid, Antidepressive, Antimalarial, Atropine, Aurothioglucose, Barbiturates, Belladonna, Bismuth, Cimetadine, CNS stimulant, Cocaine, Codeine, Coumarin, Griseofulvin, Heparin, Insulin, Iodide, Niacinamide, Opiates, Penicillin, Phenobarbital, Procaine, Quinacrine, Streptomycin, Tetracyclines, Thiamine Chloride, Thiouracil
  55. Pruritus Ani
    Chloroquine, Codeine, Liver Extract, Tetracyclines
  56. Purpura
    ACTH, Allopurinol, Barbiturates, Carbromal, Chlorpromazine, Corticosteroids, Coumarin, Ephedrine, Griseofulvin, Iodide, Meprobamate, Mercury, Penicillin, Quinidine, Reserpine, Sodium thiosulfate, Sulfamethoxypyridazine, Sulfonamides, Thiazides
  57. Purpura Fulminans
    Acetylsalicylic acid, Coumarin, Iodides
  58. Pustular Psoriasis
    Acetylsalicylic Acid, Antimalarials, Poliomyelitis vaccine
  59. Pustuloderma
    Bromides, Chloral hydrate, Iodides, Penicillin, Macrolide
  60. Seborrhoeic Dermatitis
    Methyldopa, Phenothiazines
  61. Scleroderma-Like Eruption
    Epoxy resin monomer, Organic solvent, Perchlorethylene, Trichlorethylene, Vinyl chloride monomer Bleomycin, Carbidopa, Penicillamine, Pentazocine, Organic solvent, Sodium valproate, Injection of paraffin or silicone.
  62. Stevens-Johnson Syndrome
    Allopurinol, Antipyrines, barbiturates, Chlormezanone, Chloroquine, Chlorpropamide, Cotrimoxazole, Cough Mixtures, Meprobamate, NSAID, Phenacetin, Phenobarbital, Phenytoin, Sulfonamides
  63. Stomatitis
    Aurothioglucose, Bismuth, Chlorpromazine, Dilantin (gingivitis), Fluorides, Methotrexate, Phenobarbital, Streptomycin, Thiouracil
  64. Striae: Corticosteroids, Isoniazid
  65. Telangiectasia: Oral contraceptives
  66. Toxic Epidermal Necrolysis
    Acetazolamide, Allopurinol, Aminopyrine, Antihistaminics, Anti-pyrines, Barbiturates, Brompheniramine, Dapsone, Gold Salts, Methyl-salicylate, Nitrofurantoin, Penicillin, Phenolphthalein, Phenylbutazone, Phenytoin, Salicylates, Polio Vaccine, Sulfonamides, Tetracyclines, Tolbutamide.
  67. Urticaria
    1. Immunological mediation
    2. Drugs most commonly responsible:
    3. Enzymes, Penicillins, Pollen vaccines, Polypeptide hormone, Serum, Sulphonamides
    4. Other drugs responsible, but lower incidence:
    5. Barbiturate, Carbimazole, Cephalosporins, Cimetidine, Griseofulvin, Insulin, Metronidazole, Phenytoin, Quinidine, Synthetic adrenocorticotrophin, Tetracycline
    6. Non-immunological mediation
    7. Alcohol, Aspirin and other salicylates, Atropine, Chlortetracycline, Codeine, Dextran, Decamethonium, Morphine, NSAID, Oestrogen, Pilocarpine, Polymyxin antibiotics, Quinine, Radiographic contrast media, Scopolamine, Snake venoms, Thiamine, d-Tubocurare, Vancomycin
  68. Vasculitis
    Allopurinol, Arsenic, Captopril, Chlorpromazine, Clindamycin, Ethacrynic acid, Gold, Griseofulvin, Guanethidine, Heparin, Hydantoin, Hydralazine, Indomethacin, Insulin, Iodide, Ketoconazole, Methylthiouracil, Penicillin, Phenothiazine, Phenylbutazone, Phenytoin, Pill, Quinidine, Serum, Streptomycin, Streptokinase, Sulphonamides, Tamoxifen, Tetracycline, Thiazide, Thiouracil, Vancomycin




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