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Severe cutaneous adverse reactions in a local hospital setting: a 5‐year retrospective study
Author(s) -
Su Peiqi,
Aw Chen Wee Derrick
Publication year - 2014
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.12118
Subject(s) - medicine , culprit , retrospective cohort study , drug , epidemiology , drug withdrawal , antibiotics , drug reaction , adverse effect , demographics , adverse drug reaction , dermatology , pediatrics , surgery , pharmacology , demography , sociology , myocardial infarction , microbiology and biotechnology , biology
Background Severe cutaneous adverse reactions ( SCAR ) are rare but important causes of morbidity and mortality. Stevens‐Johnson syndrome ( SJS ), T oxic E pidermal N ecrolysis ( TEN ), and drug reaction with eosinophilia and systemic symptoms ( DRESS ) are severe cutaneous drug reactions that can be potentially life threatening. Our study aims to look at the epidemiology of SCAR in the local setting in Singapore and the underlying characteristics of our patients that may influence the drug reaction seen. Methods Data was collected retrospectively from in‐patient records in the period of J anuary 2007 to D ecember 2011. We looked at several factors: (i) patient demographics including age, gender, ethnicity, comorbidities, (ii) culprit drug(s), (iii) latent period, (iv) drug reaction observed, (v) systemic complications, (vi) length of hospital stay, (vii) treatment given, and (viii) outcomes (mortality, morbidity). Results We collected data from 42 patients. The mean age of our patients was 51.8 years. Twenty‐nine (69%) of the patients had underlying comorbidities. The most common culprit drug group was antibiotics. SJS was the most common SCAR observed (54.8%), followed by acute generalized exanthematous pustolosis ( AGEP ; 24%), TEN (11.9%), and DRESS (2%). Sixteen patients (38.1%) had complications, and there was one reported death. There was a weak correlation (correlation coefficient 0.29, P value = 0.15, 95% CI = 2.07) between early steroid therapy and the length of stay. Conclusions Antibiotics are the most common culprit drugs. The most common SCAR observed in our study was SJS . Early initiation of steroids may lead to a more favorable outcome.