Often in babies and children, after taking a drug, a drug rash appears on the body. That is not necessarily something to be alarming about. It could be a drug eruption in both baby and child . Even so, the pediatrician should take an expert look at it.
What is a drug eruption?
A drug eruption is a drug allergy . After a drug is administered, the immune system reacts to one or more active ingredients of a drug. In drug eruptions, a red, inflammatory, blistering or lumpy rash occurs on some parts of the body, and it can also spread to the whole body.
In addition to a drug eruption, other allergic reactions are possible, e.g. B. diarrhea, vomiting, swelling of the mucous membrane in the mouth and throat, sometimes also fever, especially in babies and small children.
The reaction does not even have to be related to the active substance itself. Since a drug contains many components, such as fillers, colors and flavors, stabilizers, preservatives, etc., the drug eruption can also be a reaction to one of these substances. One of the most well-known drug allergies is the penicillin allergy.
Causes
A drug eruption always occurs as an allergic reaction by the immune system to one or more of the ingredients in a drug. The inflammatory rash can appear shortly after the drug is administered, but it can also appear a few days later.
The drug eruption is more common with topical drugs. Medicines that often trigger a drug eruption include antibiotics , antifungal agents , anti-rheumatic agents , and cardiovascular agents. Local anesthetics , among other things, can trigger a drug eruption.
Symptoms, ailments & signs
A drug eruption in babies and children is usually noticed by redness and swelling. These often appear on the face, but can occur on any part of the body. The redness and swellings vary in size and texture. A drug eruption can be small and punctiform, but it can also cause large, raised swellings.
Such a rash does not necessarily have to cause discomfort. Depending on the affected part of the body, the rash is discovered more or less by chance. However, many drug eruptions in babies and children cause itching . Scratching the affected parts of the body usually increases these symptoms. Itching is annoying and can torment babies and children so badly that medication is necessary.
In addition to the itching, the drug eruption can also trigger such swellings that severe discomfort and even shortness of breath occur. Accordingly, in the event of such signs and external symptoms of a rash, a doctor must promptly clarify whether it is a rash that does not require treatment or a severe allergic reaction to a drug. Swellings can be so pronounced that severe shortness of breath or attacks of suffocation occur, which must be broken immediately with appropriate medication.
Diagnosis & course
If a drug eruption is suspected in children, the doctor will first stop the drug to see if the drug eruption was caused by this drug. If the rash then goes away, the drug eruption diagnosis is safe.
It becomes difficult when several drugs are prescribed and administered at the same time, which is not the case with babies and children, so that a drug eruption can be diagnosed relatively quickly.
A drug eruption usually occurs very quickly after a drug has been prescribed, especially in babies and children. If an inflammatory drug eruption develops in some parts of the body or all over the body immediately or within a few days after ingestion or local administration, it is suspected that a drug eruption is present.
After the drug is discontinued, the drug eruption usually resolves within a few days. Also, if the allergy is more severe, it may take a few weeks for the drug eruption to go away.
If you as a mother or father are not entirely sure and the pediatrician can not make a clear diagnosis, you should go to a dermatologist with the child and take all medicines or drugs that are administered with you.
A prick test , as it is used for other allergies, makes only limited sense in the case of drug eruptions, because it cannot record all drug allergies, mainly only antibiotics , anti-inflammatory drugs and cortisone . For a baby and toddler, it would be a torturous procedure to avoid anyway.
Complications
As a rule, a drug eruption in babies and children is not a particularly worrying complaint and does not need to be treated in every case. However, parents should always have the symptoms examined by a doctor in order to prevent possible consequential damage. The child suffers from severe reddening of the skin and a rash.
This can also be itchy. Parents should definitely forbid scratching. It is not uncommon for babies and children to experience diarrhea and vomiting as well as a general feeling of illness as a result of the drug eruption. The throat and mouth can also be swollen, which can make it difficult to eat.
Most of the time, after stopping the medication, there are no further symptoms or complications. The symptoms will then go away on their own after a few days. However, a doctor should always be consulted before drugs are discontinued or exchanged for others.
If the rash is itchy and bothersome to the child, antihistamines may be given to relieve the symptoms. There were no further complaints either. The child’s development is not affected by the disease.
When should you go to the doctor?
Drug eruptions in babies and children are not uncommon reactions to a specific drug. They are described in particular when taking antibiotics. If the rash is localized and painless and the child is otherwise symptom-free, a rash is not necessarily a reason for a doctor’s visit.
The situation is different with a very pronounced rash. This should be clarified by a pediatrician. A large, supposed rash can also be a symptom of another disease, such as measles, rubella or chickenpox.
Since these diseases can be serious without treatment and questions about the risk of infection have to be clarified, advice from a pediatrician is useful. A severe rash, which occurs very suddenly, can also mark the beginning of a severe allergic reaction. One speaks here of the so-called anaphylaxis. This can start with a rash and spread to the entire organism up to circulatory failure.
Such allergic reactions can also occur with drugs. A severe rash paired with symptoms such as itching, reddened skin or noticeable paleness, coughing, signs of shortness of breath, can therefore be a medical emergency. A doctor should be consulted immediately or, in the case of very severe forms, an ambulance should be called.
Treatment & Therapy
The measure of choice in the event of a drug eruption is always to discontinue the allergy-causing drug if it can be identified as the trigger. After stopping the drug, the drug eruption usually resolves very quickly.
If several drugs are given at the same time and the drug that causes the allergy cannot be determined, the pediatrician or dermatologist can treat the drug eruption with glucocorticoids or – if the rash causes excruciating itching – with antihistamines . Intensive medical observation and treatment is only indicated in the case of very severe allergic reactions.
Outlook & forecast
The drug eruption in babies and children has a good prognosis. The complaints are not considered to be independent illnesses but represent a reaction of the organism to the medication taken. As soon as the medication is discontinued, the skin changes in the baby and child regress. The symptoms are completely healed within a few days. The child is then considered symptom-free and cured.
The affected areas of the skin can be given a support with ointments or creams. These help the organism so that the skin can regenerate as quickly as possible and there are no scars.
If complications arise, the healing process is extended. However, they usually do not change anything in the very good prognosis of the drug eruption. The skin changes can lead to itching and as soon as you give in to it, open wounds threaten. If the wound care is not sterile, germs and pathogens can enter the organism through the open areas of the body. There is a possibility that other illnesses will develop that require treatment.
Although the prognosis for drug eruptions in babies and children is extremely positive, the body can also react when another drug is administered. A recurrence of the drug eruption cannot therefore be ruled out. The prognosis if the symptoms recur is also very good.
prevention
A drug eruption cannot be prevented, since every person could in principle react to any possible ingredient in a drug. If the family has frequent drug eruptions, e.g. B. on penicillin, it is advisable to inform the pediatrician about it. If a drug allergy is proven, it is entered in the medical record and in an allergy passport.
Aftercare
To be on the safe side, a drug eruption in babies or children should always be presented to the doctor who prescribed the drug that triggered it. In and of itself, no consequences are to be expected from a drug eruption in babies and children. The triggering preparation should, however, be changed if necessary. It is an allergic reaction to one of the active ingredients or the auxiliary substances it contains.
Such reactions can lead to other allergic symptoms in addition to the exanthema. These can sometimes appear very threatening. Therefore, in the follow-up care of the acute incident, it must be found out what the trigger for the drug eruption in the baby and child was. This substance should subsequently be avoided.
In most cases, however, it is difficult to even determine which ingredient caused these consequences. Young children should not necessarily be subjected to a prick test. Itching, redness, and swelling can potentially occur from any of the ingredients in a medication. A drug eruption in babies and children therefore requires long-term observation of the child.
Parents are encouraged to observe further unusual reactions to certain substances in order to narrow the circle of potential causers. Depending on how pronounced and serious the first drug eruption was in the baby or child, the attending physician may suggest further measures.
You can do that yourself
A drug eruption in babies and children is caused by a drug allergy, but this rash is usually harmless in nature. If the rash is localized and the child is symptom-free, the preparation can continue to be given under close observation of the relevant skin area.
However, if a drug eruption spreads quickly and itches heavily, this is always an indication of a serious allergic reaction . In this case, the drug is immediately discontinued and the affected skin areas are covered with cooling saline compresses or anti-itchy lotions. The attending physician must be consulted within the next one to two hours. If this is not available, the emergency department of the nearest clinic is the right address.
If the rash sets in only a short time after taking a drug and is accompanied by fever , diarrhea and vomiting or even swelling of the mucous membrane in the mouth and throat, there may be an acute danger to life. Only the emergency doctor who has been called can decide on further therapy. This ranges from treatment with antihistamines and cortisone to intensive medical care.
Parents are best guided by the following guidelines: The younger the child and the more directly the drug eruption is related to a drug administration, the sooner immediate medical help is indicated.