Physician’s Guide to Drug Eruptions
Jerome Z. Litt
Parthenon Publishing, Inc, One Blue Hill Plaza, PO Box 1564, Pearl River, NY 10965 USA
Comprehensive, current listing of adverse cutaneous reactions and color photographs
Important systemic syndromes, such as the drug hypersensitivity syndrome and serum sicknesslike reaction, are poorly presented. Readers might miss the opportunity to do a complete clinical evaluation if the information is unavailable
Dermatologists, physicians, and pharmacists who are confronted with rashes that might be due to drugs
Rashes can be difficult to diagnose for anyone, but even my children can cure classmates by suggesting that they have “a mild dermatitis, try some hydrocortisone cream.” The problem arises when a patient mentions a new drug started 7 days ago. Drug reactions are the core of my academic career, and I know how complicated they can be to manage.
When a drug reaction is suspected, the first step is to make the diagnosis. This book addresses this step with clinical descriptions of a few common drug reactions and a rich set of excellent color plates. This part of the text is only partially successful. Severe systemic reactions are poorly treated, and users will need other sources to help guide management.
Once the best diagnosis is made, the second step is to consider which drugs the patient is receiving and what the likelihood is that each drug caused the rash. This is where this book shines. Does diphenhydramine hydrochloride cause fixed drug eruption? Yes, and there are four good references. Has gemfibrozil caused lichen planus? Apparently so. While this approach will not answer all issues (that is still the job of clinicians), the book is an excellent up-to-date guide to what is known. It also can direct readers to the appropriate references, a very difficult task because drug eruptions are reported in obscure journals or non-indexed letters.
The organization of the text is also strong. A comprehensive list of trade names and associated generic names is provided. Products are then listed by the latter, and the list of rashes and references follows each. For specific rashes, a separate section lists all the drugs reported to cause the reaction.
Several books are available that review drug reactions in the skin, but I believe that, in many ways, this is the most clinically useful. It is comprehensive and has been updated regularly. It falls short in some areas, but that should not detract anyone interested in drug eruptions from buying this gem. It will be well used by the time the next edition is published.