FREQUENCY OF CLINICAL SPECTRUM OF ADVERSE CUTANEOUS DRUG REACTIONS AND THEIR CAUSATIVE AGENTS
Main Article Content
Keywords
adverse drug events, adverse drug reaction reporting, Cutaneous adverse drug reactions, erythema multiforme, non steroidal anti inflammatory drugs
Abstract
Drug reactions are undesired reactions that develop after the administration of the drug which is not the pharmacodynamic effect of the drug. It is seen that 10-30 % of all the reported cases of adverse drug reactions are cutaneous adverse drug reactions (CADR). We carried out this study to ascertain the frequency of the clinical spectrum of adverse cutaneous reactions and the provoking causative drugs.
Our study comprised of seventy patients who met the inclusion criteria.Biodata, demographic data and clinical details which included clinical features, duration of symptoms, history of drug ingestion and the type of drug ingested was also recorded. The CADR were diagnosed on the basis of clinical examination and histopathological grounds where required by expert dermatologists. History of drug use was recorded. Data was entered and analyzed using SPSS version 21.
Among the valid responsesthe mean age of the patients was 35.84 years with femalespreponderance71.43%.Most commonly found eruption wasmaculopapular rash 21.4%, followed by erythema multiforme (EM) 20.0%, and fixed drug eruption (FDE) 14.2%.Among the known drugs, antibiotics were the most common 41.82%, followed by NSAIDs 29.09% and anti-epileptics, 14.55%.
The clinical spectrum of CADR varies from mild skin maculopapular rashes to severe life-threatening cutaneous reactions with multi-organ involvement The pattern of ACDRs and the drugs causing them is remarkably different in ourpopulation. Knowledge of these drug eruptions, the causative drugs and the prognosticindicators is essential for the clinician.
References
2. Jhaj R, Uppal R, Malhotra S, et al. Cutaneous adverse reactions in-patients in a tertiary care hospital. Indian J DermatolVenereolLeprol. 1999;65:14-7. https://europepmc.org/article/med/20885028
3. Ahmad FU, Mahapatra AK. Phenytoininduced toxic epidermal necrolysis in a neurosurgical patient. Neurol India. 2007;55:181-2. DOI: 10.4103/0028-3886.32804
4. KamaliahMD, Zainal D, Mokhtar N, et al. Erythema multiforme, Stevens–Johnson syndrome and toxic epidermal necrolysis in northeastern Malaysia. Intern J dermatol. 1998;37(7):520-3. https://doi.org/10.1046/j.1365-4362.1998.00490.x
5. Hina A, Masood S, Jamil S, et al. (April 19, 2021) Prevalence of Clinical Spectrum of Cutaneous Adverse Drug Reactions in Patients Presenting at a Tertiary Care Hospital in Pakistan. Cureus 13(4): e14568. doi:10.7759/cureus.14568. DOI: 10.7759/cureus.14568
6. Sharma V K, Sethuraman G, Kumar B. Cutaneous adverse drug reactions: clinical pattern and causative agents--a 6 year series from Chandigarh, India. J Postgrad Med 2001;47:95 https://journals.lww.com/jopm/abstract/2001/47020/cutaneous_adverse_drug_reactions__clinical_pattern.3.aspx
7. Patel TK, Thakkar SH, Sharma DC. Cutaneous adverse drug reactions in Indian population: A systematic review. Indian dermatology online journal. 2014 Dec;5(Suppl 2):S76. DOI: 10.4103/2229-5178.146165
8. Hernandez-Salazar A, de Leon-Rosales SP, Rangel-Frausto S, et al. Epidemiology of adverse cutaneous drug reactions. A prospective study in hospitalized patients. Archives of medical research. 2006 Oct 1;37(7):899-902. https://doi.org/10.1016/j.arcmed.2006.03.010
9. Hoetzenecker W, Nägeli M, Mehra ET, et al. Adverse cutaneous drug eruptions: current understanding. InSeminars in immunopathology 2016 Jan (Vol. 38, pp. 75-86). Springer Berlin Heidelberg. DOI https://doi.org/10.1007/s00281-015-0540-2
10. Nayak S, Acharjya B. Adverse cutaneous drug reaction. Indian Journal of dermatology. 2008 Jan 1;53(1):2-8.
11. Falvo D. Effective patient education: A guide to increased adherence. Jones & Bartlett Publishers; 2010 Feb 26.
12. Fiszenson‐Albala F, Auzerie V, Mahe E, et al. A 6‐month prospective survey of cutaneous drug reactions in a hospital setting. British Journal of Dermatology. 2003 Nov 1;149(5):1018-22. https://doi.org/10.1111/j.1365-2133.2003.05584.x
13. Pudukadan D, Thappa DM. Adverse cutaneous drug reactions: clinical pattern and causative agents in a tertiary care center in South India. Indian Journal of Dermatology, Venereology &Leprology. 2004 Jan 1;70(1). https://tspace.library.utoronto.ca/retrieve/3390/dv04005
14. Garg HK, John LJ, Thomas IN, et al. Variety and Incidence of Cutaneous Adverse Drug Reactions in a UAE Hospital. Int J Med Res Prof. 2016;2(5). DOI: 10.21276/ijmrp.2016.2.5.009
15. Ding WY, Lee CK, Choon SE. Cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia. International journal of dermatology. 2010 Jul;49(7):834-41. https://doi.org/10.1111/j.1365-4632.2010.04481.x
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Dr. Humaira Talat
Dow University of Health Sciences
Dr. Farheen Ashfaq
Dow University of Health Sciences
Dr. Afshan Mughal
Dow University of Health Sciences
Dr. Reema Mirza
Dow University of Health Sciences
Dr. Sulhera Khan
Dow University of Health Sciences,
Dr. Mahwish Akber
Dow University of Health Sciences