TABLE 1

Characteristics of selected high-risk drug rashes^a

Disease	Onset	Skin findings	Hallmarks	Drug triggers	Diagnosis^b
SJS/TEN	1–3 weeks	Red/purple macules progressing to vesicles, erosions, and ulcerations	Mucous membrane involvement; Nikolsky sign	Allopurinol, antibiotics (particularly sulfonamide), antiepileptics, NSAIDs	SCORTEN
DRESS	2–6 weeks	Generalized maculopapular erythematous rash	Facial edema and redness, eosinophilia, elevated transaminases	Allopurinol, antibiotics, antiepileptics, antiretrovirals, isoniazid, NSAIDs	RegiSCAR
AGEP	48 hours	Generalized maculopapular erythematous rash with pinpoint pustules	Face, trunk, and intertriginous area; tiny pustules often difficult to see	Antibiotics, antimycotics, diltiazem, hydroxychloroquine	EuroSCAR; consider dermatoscopy
Drug-induced vasculitis	1–3 weeks	Palpable purpura	Dependent areas, reverse koebnerization	Allopurinol, amiodarone, antibiotics, beta-blockers, diuretics, metformin, NSAIDs, SSRIs	Evaluate for alternative causes of systemic vasculitis

↵a Treatment starts with immediate identification and cessation of the offending drug.
↵b Consider skin biopsy to further support diagnosis for all these rashes.
AGEP = acute generalized exanthematous pustulosis; DRESS = drug reaction with eosinophilia and systemic symptoms; EuroSCAR = European Study of Severe Cutaneous Adverse Reactions; NSAIDs = nonsteroidal anti-inflammatory drugs; RegiSCAR = Registry of Severe Cutaneous Adverse Reactions; SCORTEN = Severity-of-Illness Score for Toxic Epidermal Necrolysis; SJS/TEN = Stevens-Johnson syndrome/toxic epidermal necrolysis; SSRIs = selective serotonin reuptake inhibitors