Clinical Phenotypes of Severe Cutaneous Drug Hypersensitivity Reactions

Güvenir, H.; Arıkoğlu, Tuğba; Vezir, Emine; Mısırlıoğlu, Emine Dibek

doi:10.2174/1381612825666191107162921

Cited by 14 publications

(23 citation statements)

References 133 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,2 Cutaneous adverse drug reactions (CADRs) are the most frequent adverse events resulting from medication use. 3 CADRs encompass all adverse events related to drug eruption, regardless of aetiology. 4 Studies have shown that CADRs comprise 10%-20% of reported ADRs and have an overall incidence rate of 2%-3% in hospitalized patients and approximately 2%-6% among all patients treated, with incidence of severe CADRs (SCADRs) ranging from 0.33% to 3%.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

“…1. Violation of medical record writing and management system 46 (18) Medical records and/or prescriptions were not available for the time of the patient's visit 7 (3) Medical record writing does not meet the requirements of 'basic specification for medical record writing' 39 (16) 2. Inadequate informed consent 51 (20) Insufficient information on side effects, adverse reactions, precautions and risks of drugs.…”

Section: What Is Ne W and Con Clus I Onmentioning

confidence: 99%

See 1 more Smart Citation

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China

Zheng

Jiang

et al. 2020

J Clin Pharm Ther

View full text Add to dashboard Cite

What is known and objective To investigate the general characteristics, economic burden, causative drugs and medical errors associated with litigation involving severe cutaneous adverse drug reactions (SCADRs) in China, with the aims of improving rational medication use and reducing the extent of damage from SCADRs. Methods This study analysed 150 lawsuit judgements involving SCADRs from 2005 to 2019, collected from China Judgments Online. Results and discussion In total, 50% of lawsuits stemmed from SCADRs occurring in general hospitals. The average time elapsed from the date of occurrence of the SCADRs to the end of litigation procedures was 1055 days. Of the patients involved, 51% were female and more than two thirds (69%) were under 60 years old. The most common outcome of SCADRs was death (39%), followed by disabilities (30%). The average responsibility of the medical provider was 48 ± 29%. The average amount of compensation was $43 424. Of the cases studied, 51% of SCADRs were Stevens‐Johnson syndrome or toxic epidermal necrolysis, which together accounted for 75% of cases with known clinical subtype. The overall average economic burden of SCADRs was $99 178, of which indirect costs made up the largest proportion (more than 60%). The most common causative drug groups were antimicrobial drugs (49%), Chinese patent medicine and Chinese herbal medicine (17%), and antipyretic analgesics (16%). Finally, 61% of medical errors were found to stem from violation of duty of care, 20% from violation of informed consent and 18% from violations related to the medical record writing and management system. What is new and conclusion Severe cutaneous adverse drug reactions not only severely affect patient survival and quality of life, but also impose a heavy economic burden in terms of health care and societal costs. Medical providers should be better educated on strategies to reduce risk to patients and establish mechanisms of risk sharing and management.

show abstract

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

Section: What Is Ne W and Con Clus I Onmentioning

confidence: 99%

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China

Zheng

Jiang

et al. 2020

J Clin Pharm Ther

View full text Add to dashboard Cite

show abstract

“…(%) 58 (78.4) Mean eosinophil count, × 10 9 /L 0.19[0.22] Eosinophilia-no. (%) 56 (75.7) Median AST, U/L [IQR] 18.0 [12] Elevated AST*–no. (%) 7 (9.5) Median ALT, U/L [IQR] 22.0[24] Elevated ALT*–no.…”

Section: Resultsmentioning

confidence: 99%

“…The prolonged AGEP following the use of hydroxychloroquine was formerly reported in the literature as case reports [12] , [13] , [14] , [15] . However, to the best of our knowledge, no study has yet to compare the improvement time of hydroxychloroquine-induced AGEP with other drugs.…”

Section: Discussionmentioning

confidence: 99%

Acute generalized exanthematous pustulosis with a focus on hydroxychloroquine: A 10-year experience in a skin hospital

Nili

Zarei

Ghamari

et al. 2020

International Immunopharmacology

View full text Add to dashboard Cite

show abstract

“…The sequelae of events that resulted in a diagnosis of antibiotic allergy, with all children in our study, began with a red, raised rash, but rarely any further investigations. Whereas antibiotic allergy may present with a cutaneous manifestation and necessitate withdrawal, 18 infants and children develop rash for a multitude of other reasons, including rarely related Immunoglobulin E-mediated allergic conditions, 10 as well as viruses 19 and infections. 20 Macular/ popular rashes in childhood are often harmless and are commonly attributed to viral infections.…”

Section: Discussionmentioning

confidence: 99%

GRAded oral challenge for Drug allergy Evaluation—Delabelling described through families' voices

Protudjer

Golding

Bouwman³

et al. 2020

Clin Experimental Allergy

View full text Add to dashboard Cite

Background Children are often diagnosed with an antibiotic allergy, with little investigation to confirm whether it is a true allergy. Recent studies support the use of oral challenges to confirm antibiotic allergy. Yet, little is known about families' perceptions of these challenges, or experiences of living with a misdiagnosis, often for many years. Objective To describe how families with a child previously labelled as “antibiotic allergic,” but who has subsequently been delabelled, perceive the experience of misdiagnosis and subsequent delabelling. Methods We performed semi‐structured interviews with parents whose children had recently completed a graded oral challenge for antibiotic allergy. Interview transcripts were analysed concurrently, but independently, by two investigators, using content analysis. Results A total of 15 parents (14 individual interviews; 1 mother‐father dyad) participated. Children were, on average, 5.04 ± 4.5 years and were first diagnosed in infancy (mean age: 1.82 ± 1.48 years) subsequent to a rash (14/14; 100%), and commonly at a walk‐in clinic (6/14; 42.9%). We identified four themes: (1) A red, raised rash results in a quick diagnosis despite a lack of testing, (2) sensitive care allays concerns, (3) delabelling brings relief, but also mystery and calls for proper diagnoses, and (4) quick diagnoses are reckless, but manageable through downward comparisons. Conclusion and Clinical Relevance These findings underscore the importance of a careful physical examination and clinical history of the patient, but also an ongoing dialogue to support families, both of which would ideally begin at the time of initial investigation.

show abstract

Clinical Phenotypes of Severe Cutaneous Drug Hypersensitivity Reactions

Cited by 14 publications

References 133 publications

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China

Acute generalized exanthematous pustulosis with a focus on hydroxychloroquine: A 10-year experience in a skin hospital

GRAded oral challenge for Drug allergy Evaluation—Delabelling described through families' voices

Contact Info

Product

Resources

About