Guidelines
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Photo Gallery

Urticaria

Features of typical urticaria:

1) Central swelling with surrounding erythema (variable size) 2) Pruritus 3) Duration of individual lesions <24h

Urticaria

Photo credit: Allergy and Asthma Network https://allergyasthmanetwork.org/allergies/hives/

Urticaria

Photo credit: Brown Skin Matters https://www.instagram.com/brownskinmatters/?hl=e

Urticaria

Photo credit: https://dermnetnz.org/

Angioedema

Features of typical angioedema:

1) Subcutaneous swelling with surrounding erythema 2) May or may not be itchy. Often accompanied by pain and tenderness. 3) Duration of lesions 24-48 hr

Angioedema

Photo credit: Usatine, R. (2009). The color atlas of family medicine. New York: McGraw-Hill Medical.

Maculopapular Rashes

Features of typical maculopapular rashes:

1) Duration >24h 2) Consists of flat macules and raised papules 3) Starts in one area then spreads 4) Fine scaling or dry skin

Macular papular rash

Photo credit: https://www.dermnetnz.org/

Macular papular rash

Photo credit: Primary Care Dermatology Society

Macular papular rash
 

Photo credit: dermnet.nz.org/

Macular papular rash

Photo credit: https://dermnetnz.org/

Severe Cutaneous Adverse Drug Reactions

Severe systemic or cutaneous adverse drug reactions should be suspected for any patients with:

  • Mucous membrane involvement
  • Skin Desquamation
  • Vasculitis
  • Arthritis/ Arthralgia
  • Lymphadenopathy
  • On-going, unexplained fever
  • Evidence of kidney or liver involvement
  • Generalized pustulosis

Lip involvement and desquamation in SJS
 

Photo Credit: Oscar Tamez-Rivera, Nataly Mercado and Amarante Gutiérrez-Martin
Pediatrics in Review May 2017, 38 (5) 234; DOI: https://doi.org/10.1542/pir.2015-0114

Vasculitis rash with target lesions

Vasculitic rash and desquamation with SJS

Conjunctivitis in SJS

Photo credit: Wang, JW, Rixen JJ, Goins KM, Kitzmann AS. Ocular Manifestations of Stevens-Johnson Syndrome: 13-year-old female with mucosal and dermatologic eruptions. EyeRounds.org. August 20, 2014; available from http://EyeRounds.org/cases/192-Stevens-Johnson.htm

Resolving vasculitic lesion

Generalized pustulosis