Severe Cutaneous adverse reactions in a local hospital setting in Bangladesh: a 5-year retrospective study
Keywords:
SCADRs, SJS, TEN, Anticonvulsant drugs, Drug eruptionAbstract
Background: Cutaneous Adverse Drug Reactions (CADR) are frequent adverse drug reactions that can present in various ways and range in severity. The most typical drug allergy symptom is skin manifestation, underscoring how crucial it is to identify the offending medication and stop using it—doing so could even save your life—in some cases. Aim: This study aimed to determine the frequency of severe and deadly cutaneous adverse drug reactions (SCAR) in hospitalized Bangladeshi patients and calculate the prevalence of severe and deadly cutaneous adverse drug reactions (SCAR) in hospital patients. Methods: Inpatient records from the Department of Dermatology and Venereology, Combined Military Hospital, Dhaka, were used to gather data retroactively throughout the time frame of January 2012 to December 2016. Age, gender of the patients, implicated drugs, observed drug reactions, course of treatment, and results were some variables we examined (mortality and morbidity). Results: Clinical evaluation of the study participants revealed that 46% of cases were SJS, 29% were TEN, 16% were DRESS, and 10% were AGEP. The age range of 31 to 50 years saw the highest incidence (46%) of cases. Drug classes that contain anticonvulsants may have the highest incidence of SCADRs. Phenytoin caused 16% of patients' SCADRs, followed by carbamazepine in 22% of instances and phenobarbital in 14% of cases. Conclusion: SCADRs have been a serious issue in healthcare for decades. The majority of SCADR is caused by medications that doctors give. SCADRs were more frequently observed with anticonvulsants from the carbamazepine and phenytoin categories. Continuous monitoring of SCADRs is necessary to develop preventive measures.References
Cho YT, Chu CY. Treatments for Severe Cutaneous Adverse Reactions. J Immunol Res. 2017;2017:1–9.
Su P, Aw CWD. Severe cutaneous adverse reactions in a local hospital setting: a 5-year retrospective study. Int J Dermatol. 2014 Nov;53(11):1339–45.
Dimri D. Retrospective Analysis of Pattern of Cutaneous Adverse Drug Reactions in Tertiary Hospital of Pauri Garhwal. J Clin Diagn Res [Internet]. 2016 [cited 2023 Feb 27]; Available from: http://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2016&volume=10&issue=5&page=FC01&issn=0973-709x&id=7736
Iffat Hasan, Konchock Dorjay, Parvaiz Anwar. Thalidomide in Dermatology: Revisited. Indian J Dermatol. 60(2):213.
Bates DW. Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention. JAMA. 1995 Jul 5;274(1):29.
Lazarou J, Pomeranz BH, Corey PN. Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies. JAMA. 1998 Apr 15;279(15):1200.
Szatkowski J, Schwartz RA. Acute generalized exanthematous pustulosis (AGEP): A review and update. J Am Acad Dermatol. 2015 Nov;73(5):843–8.
Nayak S, Acharjya B. Adverse cutaneous drug reaction. Indian J Dermatol. 2008;53(1):2.
Lin CC, Chen CB, Wang CW, Hung SI, Chung WH. Stevens-Johnson syndrome and toxic epidermal necrolysis: risk factors, causality assessment and potential prevention strategies. Expert Rev Clin Immunol. 2020 Apr 2;16(4):373–87.
Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (drug rash with eosinophilia and systemic symptoms: DRESS). Semin Cutan Med Surg. 1996 Dec;15(4):250–7.
Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. 2007 Mar;156(3):609–11.
Ang CC, Wang YS, Yoosuff ELM, Tay YK. Retrospective analysis of drug-induced hypersensitivity syndrome: A study of 27 patients. J Am Acad Dermatol. 2010 Aug;63(2):219–27.
Coopman SA, Johnson RA, Platt R, Stern RS. Cutaneous Disease and Drug Reactions in HIV Infection. N Engl J Med. 1993 Jun 10;328(23):1670–4.
Patel RM, Marfatia YS. Clinical study of cutaneous drug eruptions in 200 patients. Indian J Dermatol Venereol Leprol. 2008;74(4).
Hasan R, Akhtar N, Begum M, Ali ME, Paul K, Zakaria A, et al. Cutaneous morphological patterns of adverse drug reactions: a study of 50 cases.
Sushma M, Noel MV, Ritika MC, James J, Guido S. Cutaneous adverse drug reactions: a 9-year study from a South Indian Hospital: CUTANEOUS ADVERSE DRUG REACTIONS. Pharmacoepidemiol Drug Saf. 2005 Aug;14(8):567–70.
Zaraa I, Jones M, Trojjet S, Cheikh Rouhou R, El Euch D, Mokni M, et al. Severe adverse cutaneous drug eruptions: epidemiological and clinical features: Severe adverse cutaneous drug eruptions. Int J Dermatol. 2011 Jul;50(7):877–80.
Pudukadan D, Thappa DV. Adverse cutaneous drug reactions: Clinical pattern and causative agents in a tertiary care center in South India. Indian J Dermatol Venereol Leprol. 2004;70(1):20–4.
Lee H Y, Thirumoorthy T, Pang S M. Cutaneous adverse drug reactions in hospitalised patients. Singapore Med J. 2010;51(10):767.
Patel RM, Marfatia YS. Clinical study of cutaneous drug eruptions in 200 patients. Indian J Dermatol Venereol Leprol. 2008;74(4).
Criado PR, Criado RFJ, Vasconcellos C, Ramos R de O, Gonçalves AC. Reações cutâneas graves adversas a drogas - aspectos relevantes ao diagnóstico e ao tratamento - Parte I - Anafilaxia e reações anafilactóides, eritrodermias e o espectro clínico da síndrome de Stevens-Johnson & necrólise epidérmica tóxica (Doença de Lyell). An Bras Dermatol. 2004 Aug;79(4):471–88.