The American Journal of Medicine
Volume 123, Issue 4 , Pages 296-303, April 2010

Toxic Exanthems in the Adult Population

  • Nicole F. Vélez, MD

      Affiliations

    • Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • Department of Dermatology, Brigham and Women's Hospital, Boston, Mass
  • ,
  • Arturo P. Saavedra-Lauzon, MD, PhD

      Affiliations

    • Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • Department of Dermatology, Brigham and Women's Hospital, Boston, Mass
    • Corresponding Author InformationRequests for reprints should be addressed to Arturo P. Saavedra-Lauzon, MD, PhD, Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115

Abstract 

Frequently the internist is confronted with the nonspecific exanthematous eruption. While often a sign of a benign and self-limiting process, an exanthem also might herald the development of a more severe systemic syndrome. Infections, immune-mediated processes, drug reactions, a neoplasm, and familial syndromes with poor prognoses might all manifest initially with an exanthem. A thorough history and complete physical examination should be performed on all patients who present with an exanthem. Characterization of the exanthem morphology, other physical examination findings, and review of systems can help guide laboratory testing and ensure prompt diagnosis and early treatment of potentially life-threatening conditions. This article provides a brief overview of the conditions that must be considered in the evaluation of an ill patient with an exanthem.

Keywords: Autoinflammatory syndrome, Drug reaction, Exanthem, Morbilliform rash, Systemic inflammatory response, Toxic shock syndrome

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 Funding: None.

 Conflict of Interest: The authors deny any conflicts of interest.

 Authorship: Both authors had access to the data and played a role in writing this manuscript.

PII: S0002-9343(09)01066-3

doi:10.1016/j.amjmed.2009.09.029

The American Journal of Medicine
Volume 123, Issue 4 , Pages 296-303, April 2010