Les éruptions des enfants traités par des médicaments courants : résultent-elles d'une hypersensibilité médicamenteuse et quel bilan faut-il effectuer ? § Skin rashes in children treated with commonly used drugs: Do they result from drug hypersensitivity and which work-up should be performed?

Suspected allergic reactions to drugs and biological substances (anti-infectious drugs and non-opioid analgesics, antipyretics and non-steroidal anti-inflammatory drugs especially) are reported in 5 to 12% of children. Most frequent reactions are morbilliform/maculopapular and unidentified rashes (60–80%), and urticaria and/or angioedema (20–30%). Other cutaneous and respiratory reactions, and severe anaphylaxis, are rare. The results of studies based on allergological tests and/or microbiological/serological tests clearly show that, except for a few types of reactions, especially anaphylactic and/or immediate reactions, and potentially harmful toxidermas, most reactions to commonly used drugs and biological substances in children do not result from drug hypersensitivity, but are rather a consequence of the febrile, infectious and/or inflammatory diseases for which the drugs have been prescribed, and/or from a promoting effect of drugs on viral replication. Thus, allergological work-up based on a detailed analysis of clinical history, skin tests (if validated), biological tests (if available and validated), and challenge/provocation tests