Reações cutâneas graves adversas a drogas: aspectos relevantes ao diagnóstico e ao tratamento - Parte II

As reacoes cutâneas graves adversas a droga sao as que geralmente necessitam de internacao hospitalar, por vezes em unidade de terapia intensiva ou de queimados, com observacao minuciosa dos sinais vitais e da funcao de orgaos internos. O objetivo e descrever estas reacoes facilitando o seu reconhecimento e tratamento. Fazem parte deste grupo a Sindrome de Hipersensibilidade a Droga (SHD), a Pustulose Exantematica Generalizada Aguda (PEGA), a Necrose Cutânea induzida por Anticoagulante, as Vasculites de Pequenos Vasos (VPV), a Vasculite de Hipersensibilidade ao Propiltiouracil (VHP) e as Reacoes tipo Doenca do Soro (RDS). A SHD tem-se tornado de elevada relevância clinica devido ao uso amplo dos anticonvulsivantes aromaticos e da dapsona, utilizada no tratamento de doencas como a acne e a hanseniase. A PEGA e determinada principalmente pelos derivados beta-lactâmicos e tem como principal diagnostico diferencial a psoriase pustulosa generalizada. As VPV tegumentares podem refletir uma doenca multissistemica subjacente, com danos graves em orgaos nobres, como os rins, pulmoes e sistema hematologico, com morbidade elevada e possivel letalidade. Abordamos as caracteristicas clinicas e o tratamento destas reacoes adversas a droga.

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