Clinical aspects and therapeutic approach of drug-induced adverse skin reactions in a quaternary hospital: a retrospective study with 219 cases

Martins, Júlia Chain; Seque, Camila Arai; Porro, Adriana María

doi:10.1016/j.abd.2021.06.008

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…SCARs are rare and accounted for only 16.2% of all CARs in our patients. Variable rates were found in studies from Malaysia (15.8%) [ 5 ], China (22%) [ 6 ], India (6.9%) [ 7 ], and Brazil (34.2%, 30%) [ 8 , 9 ]. Studies on CARs appear to be limited in general in the Middle East.…”

Section: Discussionmentioning

confidence: 99%

Severe Cutaneous Adverse Drug Reactions at a Tertiary Care Center in Saudi Arabia

AlJasser

2023

Dermatology Research and Practice

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Background. Severe cutaneous adverse drug reactions (SCARs), although rare, are known to be associated with significant morbidity and mortality. SCARs include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and acute generalized exanthematous pustulosis (AGEP). Studies on SCARs are limited in Saudi Arabia. This study aims to characterize SCARs at a tertiary care center in Saudi Arabia. Methods. A cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. All inpatient and emergency department consultations to dermatology were electronically reviewed during the period from January 2016 to December 2020. All patients who developed an adverse cutaneous drug reaction were enrolled. Detailed analysis was performed only for SCARs. The culprit medication was determined based on the latency period, history of previous intake of the medication, and drug notoriety. Results. There were 3050 hospital consultations to dermatology during the study period. Cutaneous adverse drug reactions constituted 253 (8.3%) cases. A total of 41 patients with SCARs were identified, accounting for 16.2% of all cutaneous drug reactions. Antibiotics and anticonvulsants were the most common causative drug groups accounting for 28 (68.3%) and 9 (22%) cases, respectively. DRESS was the most common SCAR. The latency period was the longest for DRESS and shortest for AGEP. Vancomycin was responsible for approximately a third of DRESS cases. Piperacillin/tazobactam was the most common cause for SJS/TEN and AGEP. The majority of drugs causing AGEP were antibiotics. The mortality rate was the highest in SJS/TEN (5/11 (45.5%)), followed by DRESS (1/23 (4.4%)) and AGEP (1/7 (14.3%)). Conclusion. SCARs are rare in Saudis. DRESS appears to be the most common SCAR in our region. Vancomycin is responsible for most cases of DRESS. SJS/TEN had the highest mortality rate. More studies are required to further characterize SCARs in Saudi Arabia and Arabian Gulf countries. More importantly, thorough studies of HLA associations and lymphocyte transformation tests among Arabs with SCARs are likely to further improve patient care in the Arabian Gulf region.

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Section: Discussionmentioning

confidence: 99%

Severe Cutaneous Adverse Drug Reactions at a Tertiary Care Center in Saudi Arabia

AlJasser

2023

Dermatology Research and Practice

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Drug-induced skin reactions in hospital patients

2022

Reactions Weekly

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Toxic epidermal necrolysis following heart transplantation may caused by cefoperazone sodium and sulbactam sodium

Xiaodong,

Min,

Liming

et al. 2024

J Cardiothorac Surg

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Background The outcome of heart transplantation is significantly affected by perioperative infections. Individualised immunosuppression strategies are essential to reduce the risk of such infections. Case presentation We report the successful management of a 56-year-old male patient diagnosed with dilated cardiomyopathy who underwent heart transplantation. During the perioperative period, the patient was prescribed cefoperazone sodium and sulbactam sodium, which induced a severe skin reaction: toxic epidermal necrolysis (TEN). The patient was treated with prednisone, immunoglobulins, etanercept, and other active immunomodulatory measures, together with an individualised anti-rejection regimen and physical therapy. The systemic rash resolved within a month, and the patient was successfully discharged after surgery. Conclusion Effective management of heart transplantation necessitates balancing immunosuppression and infection prevention. Individualised immunosuppressive strategies are critical for optimal clinical outcomes.

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Clinical aspects and therapeutic approach of drug-induced adverse skin reactions in a quaternary hospital: a retrospective study with 219 cases

Cited by 3 publications

References 28 publications

Severe Cutaneous Adverse Drug Reactions at a Tertiary Care Center in Saudi Arabia

Severe Cutaneous Adverse Drug Reactions at a Tertiary Care Center in Saudi Arabia

Drug-induced skin reactions in hospital patients

Toxic epidermal necrolysis following heart transplantation may caused by cefoperazone sodium and sulbactam sodium

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