Current aspects of developing vancomycin-associated dermatoses and their diagnosis
Authors:   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation, Gantsgorn E. V. , Safronenko A. V. ,   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation, Maksimov M. L. ,   Kazan State Medical Academy - Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Malleev I. M. ,   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation, Baloyan A. A. ,   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation, Manvelyan R. M. ,   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation, Polyakova V. I. ,   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation
Published: January 2025

The article describes early and delayed adverse skin reactions due to the administration of
vancomycin, a bactericidal antibiotic from the group of glycopeptides. The main diagnostic possibilities
for the early detection of vancomycin-associated dermatoses, which, in the absence of treatment and
withdrawal of the associated drug, can lead to the death of the patient, are also presented. In clinical
practice, the manifestations of adverse reactions from the skin are often underestimated. This is due to
the lack of awareness among clinicians about the dermatological reactions of vancomycin, compared
with other adverse reactions, as well as due to the small number of studies on diagnostic and statistical
aspects of the issue under consideration. At the same time, it is important to remember that skin
symptoms are one of the first and obvious consequences of hypersensitivity, which means they have
significant diagnostic value. Some skin manifestations, in particular, the red man syndrome, can be
avoided in most cases if the nursing staff works in accordance with established schemes for the administration
of vancomycin. Other reactions are unpredictable, however, medical alertness and knowledge
of the variants of skin lesions from vancomycin and timely measures taken can offset the effects of
hypersensitivity to the drug. Currently, simple and easy-to-use tools to determine the cause-and-effect
relationships between a drug and various adverse reactions, such as the Naranjo and RegiSCAR scales
(for DRESS), have been developed and should not be neglected. Determining the true cause of skin
reactions is a difficult task due to the lack of unambiguous standardized approaches to early diagnosis.
To date, there are no practical guidelines for the diagnosis and treatment of vancomycin-associated
dermatoses, which necessitates further study of this problem.