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Morbilliform Drug Eruption — SCE Dermatology MCQ

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EasyDrug ReactionsMorbilliform Drug EruptionSCE Dermatology

A 50-year-old man develops a widespread morbilliform eruption 7-14 days after starting Amoxicillin for a chest infection. He has no mucosal involvement, systemic symptoms, or haematological abnormality. What is the most likely diagnosis?

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Correct answer: D — Morbilliform (exanthematous) drug eruption

Morbilliform (exanthematous) drug eruption is the most common adverse cutaneous drug reaction, accounting for approximately 90% of all drug eruptions. It typically develops 7-14 days after starting the causative drug (shorter on re-exposure) with a symmetrical maculopapular eruption starting on the trunk. Crucially, there is no mucosal involvement, no systemic features (fever, lymphadenopathy, organ involvement — which would suggest DRESS), and no pustulation (which would suggest AGEP). Management is drug withdrawal and symptomatic treatment with emollients and topical corticosteroids. Resolution occurs within 1-2 weeks.

Reference: BAD 2019 Drug Eruption Guidelines; NICE