Cutaneous manifestations of nonantiretroviral therapy

A drug-induced symptom complex characterized by fever and an eruption with or without internal organ involvement has been termed acute drug hypersensitivity syndrome reaction. This syndrome typically develops within 1 to 2 weeks after the initiation of drug therapy.1 It has been estimated that cutaneous drug reactions are 10-100 times more common in human immunodeficiency virus (HIV)- positive patients than in the general population,2 and one study revealed that the frequency of drug hypersensitivity in HIV-positive patients ranges from 3% to 20%.3 The most common group of drugs responsible for cutaneous hypersensitivity eruptions are antimicrobials used to treat or protect against opportunistic infections.4 Allergic reactions have been reported with trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, dapsone, pyrimethamine/sulfadoxine, aminopenicillins, clavulanate, thalido - mide, atovaquone, rifampin, probenecid, pri - maquine, isoniazid, and thioacetazone.4,5 The incidence of reactions to these agents ranges between 18% and 64%6-11 compared with only a 3.3% incidence in a general hospital population treated with TMP-SMX.12 Cutaneous drug reactions are usually mild although severe eruptions such as erythema multiforme (EM), Stevens-Johnson syn - drome (SJS), and toxic epidermal necrolysis (TEN) can occur.1 Conjunctivitis is common and hepatic and hematologic abnormalities may develop and stem from immune-mediated injury or direct toxicity.5.