Epidemiology of severe cutaneous adverse drug reactions in a University Hospital: a Five-year review
10.35460/2546-1621.2017-0031
- Author:
Angelica I GUZMAN
1
;
Arnelfa C PALIZA
1
Author Information
1. Department of Dermatology, University of Santo Tomas Hospital, Manila, Philippines
- Publication Type:Review
- Keywords:
Severe cutaneous adverse drug reactions;
Drug reaction
- MeSH:
Cicatrix;
Epidemiology
- From:
Journal of Medicine University of Santo Tomas
2018;2(1):171-184
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Severe cutaneous adverse drug reactions (SCAR) is seen in ≤5% of all hospitalized
patients. It includes Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum (SJS/TEN), drug-induced hypersensitivity syndrome/drug reaction with
eosinophilia and systemic symptoms (DIHS/DRESS)
and acute generalized exanthematous pustulosis
(AGEP).
Objectives:The main objective was to determine
the epidemiological characteristics of SCAR patients
at a tertiary hospital from 2011-2015. Specifi cally,
it aimed to determine the prevalence, demographic
characteristics and clinical profi le of SCAR patients.
Methods:All SCAR patients from 2011-2015 were
studied through a single-center, retrospective, descriptive, cross-sectional study.
Results:Sixty-eight SCAR cases were diagnosed
from 2011-2015 with a prevalence rate of 6.25
per 10,000 people. Majority were 46-55 years old
with slight female predominance. The most common
SCAR was DIHS/DRESS (50%), followed by SJS/
TEN (30%) and AGEP (20%). Eight percent had
previous drug reactions, 69% had co-morbidities
and 90% were diagnosed clinically without biopsy.
The antibiotics was the most common culprit drug
category followed by allopurinol and anticonvulsants. Prompt withdrawal of culprit drug/s, supportive therapy, systemic steroids and antihistamine, topical emollients and saline compress were mainstay
of treatment. Mortality rate was 4% for all SCAR
categories
Conclusion:The epidemiology of SCAR in this
study is similar to those reported in other literature.
The adults were commonly involved; DIHS/DRESS
was the most common SCAR with antibiotics being
the most common culprit. Prompt withdrawal and
supportive therapy were essential. Systemic steroid,
antihistamine; topical emollients and saline compress
resulted in improvement of patients. In contrast, there
was lower prevalence rate with slight female predominance; and lower mortality rate even with the
use of systemic steroids.
- Full text:JMUST 8.pdf
