Key Points

• Morbilliform drug reactions occur 1 to 2 weeks after initial exposure but occur much quicker (1-3 days) on repeat exposure.

• Urticaria can be acute or chronic and is triggered by drugs, infections, arthropods, autoimmune disease, food, and even emotional stress.

• The mainstay of therapy for urticaria is avoidance of known triggers and antihistamines.

• Oral corticosteroids for urticaria should be limited to short-term therapy of severe episodes.

Figure 33-65 Body lice on seams of clothing. © Richard P. Usatine.)

• Erythema multiforme is a reaction pattern secondary to a variety of etiologic agents and characterized by distinctive target lesions.

• Half of EM cases are caused by HSV; drugs and other infections are also common causes.

• Stevens-Johnson syndrome and toxic epidermal necrolysis typically occur 7 to 21 days after starting NSAIDS, antibiotics, or antiepileptics.

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