Drug Hypersensitivity Reactions Presenting as a Morbilliform Eruption With Islands of Sparing [letter]

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Cutaneous adverse drug reactions are common in hos­pitalized patients and contribute to patient morbidity, prolonged hospital stays, and the rising cost of health­care. In the hospitalized patient with a drug eruption and an extensive medication list, identifying the culpa­ble drug often is a challenging task. Physicians relying on clinical and histopathological clues must recognize a wide range of clinicopathologic entities that comprise cutaneous manifestations of drug reactions. Well-described patterns include morbilliform, urticarial, papulosquamous, lichenoid, bullous, erosive, pustular, eczematous, and fixed drug eruptions. Two cases of cephalosporin-induced drug eruptions manifesting as widespread morbilliform eruptions with islands of spar­ing and histologic evidence of spongiotic dermatitis on skin biopsy were diagnosed at the Columbia University Medical Center (CUMC), New York, New York.


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