Drug-induced rash

Purpura in the context of a drug reaction may be an isolated skin reaction, or it may be a manifestation of drug-induced thrombocytopenia or drug-induced vasculitis. Hydralazine is associated with drug-induced lupus-like syndrome that can present with a vasculitic purpuric rash. Systemic features such as fever, malaise and arthralgia may be present, and other organs including the liver, kidney and heart may be affected. Anti-histone antibodies may also be present. The drug should be stopped immediately and systemic corticosteroids may be of benefit. Other drugs associated with a purpuric skin rash include aspirin, sulphonamides, penicillin, thiazides, furosemide and corticosteroids.