Faculty of Medicine, University of Belgrade.
University Children's Hospital of Belgrade, Belgrade, Serbia.
Curr Opin Allergy Clin Immunol. 2021 Aug 1;21(4):335-339. doi: 10.1097/ACI.0000000000000749.
The true exanthematous reactions to drugs in children are rare and overdiagnosed. Drugs may cause exanthema either due to inducing an immune response or because of their interaction with viruses, if drugs are taken in the course of a viral infection. Also, viral infections are very often in children and they can provoke an exanthema which is difficult to differentiate from exanthematous reactions to drugs. Consequently, the majority of children are incorrectly labeled as 'allergic'.
The correct diagnosis of exanthematous drug reactions in children is still an important and hot topic. Most information about the approach and management of drug hypersensitivity in children is applied from available guidelines and consensus statement for adults. Recently, a systematic clinical approach for timely differential diagnosis and management of rashes in children who present a cutaneous exanthema while receiving a drug, is proposed.
It is important to consider the detailed clinical history of appearing and developing exanthematous drug reaction, as well as physical examination which includes the description and the distribution of exanthema and at the end making the appropriate diagnosis. Thus, it could reduce overdiagnosis and promote appropriate procedures, that will prevent the overlabeling of drug hypersensitivity in children.
儿童真正的药物疹反应很少见且被过度诊断。药物可能因诱导免疫反应或与病毒相互作用而引起疹，如在病毒感染过程中服用药物。此外，病毒感染在儿童中非常常见，它们可引发疹，难以与药物疹反应区分。因此，大多数儿童被错误地贴上“过敏”的标签。
儿童药物疹反应的正确诊断仍然是一个重要且热门的话题。大多数关于儿童药物过敏的处理和管理的信息都来自于成人的现有指南和共识声明。最近，提出了一种针对接受药物治疗时出现皮疹的儿童进行及时鉴别诊断和管理的系统临床方法。
考虑出现和发展药物疹反应的详细临床病史以及包括描述和分布的体格检查非常重要，最后做出适当的诊断。这样可以减少过度诊断，并促进适当的程序，防止儿童药物过敏的过度标签化。
