Clinical spectrum of cutaneous adverse drug reactions in the peri procedural period: a case series

Abstract

Cutaneous adverse drug reactions (CADRs) are among the frequent adverse effects of medications prescribed during the postoperative period. Their diverse clinical presentations often pose diagnostic challenges, particularly when eruptions develop after completion of short-course of therapy following surgical and medical interventions. A prospective observational case series of patients presenting with suspected CADR over a 6-month period was conducted. Clinical characteristics, suspected medications, morphology, latency, treatment, and outcomes were assessed. Seventeen patients were identified, with the onset of skin lesions ranging from post intervention day 2 to day 12. The majority of patients (11/17, 64.7%) developed cutaneous eruptions between 5 and 10 days after drug exposure. Maculopapular exanthem was the predominant presentation, observed in 13 patients (76.5%), including one case with accompanying pustules. An acneiform eruption and erythematous macules were observed in one patient each (5.9%), while erythematous papules were observed in 2 (11.8%) patients. Photoexposed areas were involved in 8 patients (47.1%). Most patients had received short course of postoperative antibiotics and/or NSAIDs before the onset of the eruption. Appropriate dermatological management resulted in complete recovery in most of the patients. Delayed perioperative CADRs were most commonly manifested as maculopapular exanthems in our series, although a spectrum of atypical morphologies were also observed. Recognition of these varied clinicomorphological presentations especially after completion of postoperative antimicrobial therapy may facilitate timely diagnosis and appropriate management.