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Azathioprine hypersensitivity is an uncommon, potentially life-threatening reaction that typically occurs in the first several weeks of therapy. Its manifestations may resemble those of anticonvulsant hypersensitivity: They are idiosyncratic and not dose related. Skin lesions have sometimes been reported in patients with azathioprine reactions, whereas in other hypersensitivity syndromes (e.g., DRESS), skin lesions are common.
These authors observed two patients, one with Crohn disease and one with systemic lupus erythematosus (LE), who had skin eruptions as part of an “azathioprine hypersensitivity reaction.” Rechallenge in one patient produced a rapid recurrence. The authors describe the eruptions in these patients as consistent with Sweet…