Derm

Drug Reaction in HIV

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Drug Reaction in HIV, Hypersensitivity and Pruritic Syndrome

  • Mechanism
  1. Increased incidence Hypersensitivity cutaneous reaction
  • Etiology
  • Medication Reaction
  1. NNRTI's (especially Nevirapine)
  2. Abacavir (Ziagen)
    1. nRTI with life-threatening Hypersensitivity Reaction
  3. Sulfa
  4. Dapsone
  • Differential Diagnosis
  1. See HIV Related Rash
  • Signs
  1. Mild-Moderate reactions
    1. Maculopapular eruptions
    2. Urticaria
    3. Fixed Drug Eruptions
  2. Severe reactions
    1. Exfoliative Erythroderma
    2. Erythema Multiforme
    3. Stevens-Johnson Syndrome
  • Management
  1. Not usually necessary to discontinue offending drug
    1. Spontaneous resolution in 70-80% cases in 7-10 days
    2. Serious reactions require drug discontinuation
  2. Antipruritics
  3. Antipyretics