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Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study

BACKGROUND: Drug eruptions range from transient erythema to the life threatening severe cutaneous adverse reactions (SCAR) that encompass Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and system...

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Autores principales: Sasidharanpillai, Sarita, Riyaz, Najeeba, Khader, Anza, Rajan, Uma, Binitha, Manikoth P, Sureshan, Deepthi N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318022/
https://www.ncbi.nlm.nih.gov/pubmed/25657416
http://dx.doi.org/10.4103/0019-5154.147834
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author Sasidharanpillai, Sarita
Riyaz, Najeeba
Khader, Anza
Rajan, Uma
Binitha, Manikoth P
Sureshan, Deepthi N
author_facet Sasidharanpillai, Sarita
Riyaz, Najeeba
Khader, Anza
Rajan, Uma
Binitha, Manikoth P
Sureshan, Deepthi N
author_sort Sasidharanpillai, Sarita
collection PubMed
description BACKGROUND: Drug eruptions range from transient erythema to the life threatening severe cutaneous adverse reactions (SCAR) that encompass Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms complex (DRESS). AIMS AND OBJECTIVES: To study the clinical and epidemiological aspects of cutaneous adverse drug reactions (CADR). MATERIALS AND METHODS: Ethical clearance was obtained from the institutional ethics committee. All patients admitted in the Dermatology ward of our tertiary care hospital with CADR (those who fit in the category of probable or possible drug reaction as per WHO casuality assessment) from first September 2011 to 31(st) August 2012 were included in this cross sectional study after obtaining written informed consent. The drug reaction patterns observed in the study population were determined and the common offending drugs were identified. RESULTS: In the study, population of males outnumbered females and the majority were between 46 and 60 years of age. The commonest reaction pattern observed was SJS- TEN spectrum of illness and aromatic anticonvulsants were the common offending drugs. Prompt withdrawal of the culprit drug and administration of systemic steroids with or without I/V Ig reverted the adverse reaction in all except one. CONCLUSION: Severe drug reactions predominated as the study population was comprised of inpatients of a tertiary referral centre. Though; previous authors had reported a mortality rate of up to 20% in DRESS, all our patients with this reaction pattern, responded well to treatment. The mortality rate among TEN cases was much lower than the previous reports. Early diagnosis, prompt withdrawal of the suspected drug, careful monitoring for development of complications and immediate intervention can improve the prognosis of CADR.
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spelling pubmed-43180222015-02-05 Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study Sasidharanpillai, Sarita Riyaz, Najeeba Khader, Anza Rajan, Uma Binitha, Manikoth P Sureshan, Deepthi N Indian J Dermatol E-IJD Original Article BACKGROUND: Drug eruptions range from transient erythema to the life threatening severe cutaneous adverse reactions (SCAR) that encompass Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms complex (DRESS). AIMS AND OBJECTIVES: To study the clinical and epidemiological aspects of cutaneous adverse drug reactions (CADR). MATERIALS AND METHODS: Ethical clearance was obtained from the institutional ethics committee. All patients admitted in the Dermatology ward of our tertiary care hospital with CADR (those who fit in the category of probable or possible drug reaction as per WHO casuality assessment) from first September 2011 to 31(st) August 2012 were included in this cross sectional study after obtaining written informed consent. The drug reaction patterns observed in the study population were determined and the common offending drugs were identified. RESULTS: In the study, population of males outnumbered females and the majority were between 46 and 60 years of age. The commonest reaction pattern observed was SJS- TEN spectrum of illness and aromatic anticonvulsants were the common offending drugs. Prompt withdrawal of the culprit drug and administration of systemic steroids with or without I/V Ig reverted the adverse reaction in all except one. CONCLUSION: Severe drug reactions predominated as the study population was comprised of inpatients of a tertiary referral centre. Though; previous authors had reported a mortality rate of up to 20% in DRESS, all our patients with this reaction pattern, responded well to treatment. The mortality rate among TEN cases was much lower than the previous reports. Early diagnosis, prompt withdrawal of the suspected drug, careful monitoring for development of complications and immediate intervention can improve the prognosis of CADR. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4318022/ /pubmed/25657416 http://dx.doi.org/10.4103/0019-5154.147834 Text en Copyright: © Indian Journal of Dermatology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle E-IJD Original Article
Sasidharanpillai, Sarita
Riyaz, Najeeba
Khader, Anza
Rajan, Uma
Binitha, Manikoth P
Sureshan, Deepthi N
Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study
title Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study
title_full Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study
title_fullStr Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study
title_full_unstemmed Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study
title_short Severe Cutaneous Adverse Drug Reactions: A Clinicoepidemiological Study
title_sort severe cutaneous adverse drug reactions: a clinicoepidemiological study
topic E-IJD Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318022/
https://www.ncbi.nlm.nih.gov/pubmed/25657416
http://dx.doi.org/10.4103/0019-5154.147834
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