Sulfonamides Antibacterial sulfonamides have a rather high risk of causing cutaneous eruptions and are among the drugs most frequently implicated in SJS and TEN. The combination of sulfamethoxazole and trimethoprim frequently induces adverse cutaneous reactions in patients with AIDS (Chap. 182). Desensitization is often successful in AIDS patients with morbilliform eruptions but is not recommended in AIDS patients who manifested erythroderma or a bullous reaction in response to their earlier sulfonamide exposure. Reaction rates are much lower with nonantibiotic sulfonamides, including diuretics or antidiabetic agents. Cross-reactivity between antibiotic and nonantibiotic sulfonamides is, at most, infrequent. . | Chapter 056. Cutaneous Drug Reactions Part 9 Sulfonamides Antibacterial sulfonamides have a rather high risk of causing cutaneous eruptions and are among the drugs most frequently implicated in SJS and TEN. The combination of sulfamethoxazole and trimethoprim frequently induces adverse cutaneous reactions in patients with AIDS Chap. 182 . Desensitization is often successful in AIDS patients with morbilliform eruptions but is not recommended in AIDS patients who manifested erythroderma or a bullous reaction in response to their earlier sulfonamide exposure. Reaction rates are much lower with nonantibiotic sulfonamides including diuretics or antidiabetic agents. Cross-reactivity between antibiotic and nonantibiotic sulfonamides is at most infrequent. Vancomycin Vancomycin causes two unusual but recognizable cutaneous reactions linear IgA bullous dermatosis a transient blistering eruption and red man syndrome. Red man syndrome occurs during rapid IV infusion of vancomycin. This is thought to be a histamine-related anaphylactoid reaction characterized by flushing diffuse maculopapular eruption hypotension and in rare cases cardiac arrest. Agents Used in Cancer Chemotherapy Since many agents used in cancer chemotherapy inhibit cell division rapidly proliferating elements of the skin including hair mucous membranes and appendages are sensitive to their effects. As a result stomatitis and alopecia are among the most frequent dose-dependent side effects of chemotherapy. Various nail abnormalities have been described onycholysis dystrophy Beau s lines white lines and pigmentation. Sterile cellulitis and phlebitis and ulceration of pressure areas occur with many of these agents. Also reported is acral erythema which begins with dysesthesia followed by redness and a painful edematous eruption of the palms and soles it is caused by cytarabine doxorubicin methotrexate and 5-fluorouracil. Urticaria angioedema and exfoliative dermatitis also have been seen as has local and .
