A 5 Year Retrospective Study on the Clinical Patterns and Treatment Outcomes of Severe Cutaneous Adverse Drug Reactions (SCARS) in Hospital Tengku Ampuan Rahimah, Malaysia
- Author:
Tee SH
;
Ng TG
- Publication Type:Journal Article
- Keywords:
Severe cutaneous adverse drug reactions (SCARs);
Stevens-Johnson syndrome (SJS);
toxic epidermal necrolysis (TEN);
drug reaction with eosinophilia and systemic symptoms (DRESS)
- From:Malaysian Journal of Dermatology
2014;33(-):9-17
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) , and drug reaction
with eosinophilia and systemic symptoms (DRESS) are severe cutaneous adverse drug reactions
(SCARs) related to a variety of medications.
Objectives: We aim to document the epidemiological features, the causative drugs and clinical
outcomes of patients with SCARs treated in Hospital Tengku Ampuan Rahimah (HTAR) between
January 2009 and December 2013.
Materials & Methods: A retrospective review of the data of all patients with SJS, TEN and DRESS
treated from January 2009 to December 2013 was retrieved and analyzed.
Results: A total of 33 SCARs patients were seen, which included SJS (25), TEN (3) and DRESS (5).
The mean age was 42.8 years. The male-to-female ratio was 1.36:1. Allopurinol (33.3%) was the
commonest offending drug, followed by antibiotics (30.3%), anticonvulsants (12.1%), non-steroidal
anti-inflammatory drugs (12.1%) and traditional medications (6.1%). Eighty percent of SJS and all
TEN and DRESS patients were given systemic corticosteroids. One patient with TEN (33.3%) was
concurrently given intravenous immunoglobulin. All SJS patients survived. Two patients with TEN
(66.7%) and one patient with DRESS (20%) succumbed due to sepsis.
Conclusion: The commonest drugs implicated for SCARs in our study were allopurinol and antibiotics.
Inappropriate use of these drugs leads to increased risk of SCARs. Early recognition and prompt
treatment of patients with SCARs may improve their outcome.
