Cutaneous adverse drug reactions (CADRs) have been found to be one of the most common adverse drug reactions (ADRs) in many studies. There is no common globally accepted tool for causality grading of ADRs to be utilized in pharmacovigilance programs. Our study aimed to show the coincidence of Naranjo method in evaluating clinically diagnosed cutaneous adverse drug reactions in Sudanese patients. The causality of the CADRs was retrospectively evaluated by using Naranjo's ADR probability scale. The study included 13 males (31.7%) and 28 females (68.3%). Of patients included in the study, 35 patients (85.4 %) had past history of drug reactions while only 6 ones (14.6 %) did not have. Scores of Naranjo algorithm ranged between 3 and 8. There was a moderate agreement between clinically diagnosed CADRs and Naranjo algorithm. 8 cases (19.51%) were assessed as 'possible' and 33 cases were assessed as 'probable' (80.49%). It was concluded that although CADRs is much more easily to be diagnosed clinically by dermatologists than other types of ADRs, it is worthy to apply this simple algorithm in dermatology centers so as not to misdiagnose some cases with simple skin eruptions and to make a more thematic decision on causality.
Objectives
Autoimmune bullous diseases vary in their clinico-epidemiological features and burden across populations. Data about these diseases was lacking in Sudan. We aimed to describe the epidemiological profile and to estimate the burden of autoimmune bullous diseases in Sudan.
Methods
This was a retrospective cross-sectional study conducted at Khartoum Dermatological and Venereal Diseases Teaching Hospital. We used routinely collected health care data, and included all patients with an autoimmune bullous disease who presented to the hospital between 2001 and 2016.
Results
Out of the 4736 patients who were admitted to the hospital during the study period, 923 (19.5%) had an autoimmune bullous disease. The average rate of patients at the hospital was 57.7 per year representing 1.3 per 100,000 population per year. After exclusion of patients where the final diagnosis was missing, 585 were included in the further analysis. Pemphigus vulgaris was the most common disease (50.9%), followed by bullous pemphigoid (28.2%), linear IgA disease/chronic bullous disease of childhood (8.4%), and pemphigus foliaceous (8.2%). Pemphigoid gestationis and IgA pemphigus constituted 1.4% and 1.2% of the cohort, respectively. Paraneoplastic pemphigus, mucous membrane pemphigoid, lichen planus pemphigoidis, bullous systemic lupus erythematosus, and dermatitis herpetiformis were rare. None of the patients had epidermolysis bullosa acquisita.
Conclusions
The clinico-epidemiological characteristics vary among the types of autoimmune bullous diseases. Females were more predominant in most of them. Sudanese patients tended in general to present at a younger age than other populations. The pool of Sudanese patients with autoimmune bullous diseases is large which requires investigation for the local risk factors and presents a field for future trials.
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