Clinical study of cutaneous drug eruptions in 200 patients

Patel, RakshaM; Marfatia, YS

doi:10.4103/0378-6323.42883

Cited by 76 publications

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“…The results are identical to a study where antiepileptics were responsible for about 8% cases. 17 Our results differ from other studies where antiepileptics were the major drug groups responsible for more than 50% cases of maculopapular eruptions. 7,9,21 NSAIDs and antimicrobials were the main culprits in causing urticaria.…”

Section: Discussioncontrasting

confidence: 56%

“…This is in consonance with other Indian studies. 7,16,17 Out of 15 (15%) cases of serious ACDRs, 8 (8%) were above 50 years of age suggesting that elderly are more likely to develop serious ACDRs. Factors which may predispose elderly to adverse drug reactions, include polypharmacy, increased potential for drug-drug interactions, age associated changes in pharmacokinetics and pharmacodynamics, pathology and use of drugs with a narrow therapeutic margin.…”

Section: Discussionmentioning

confidence: 99%

“…These results are in accordance with earlier studies. 4,7,17 Out of 12 cases of FDE, 7 (41%) were due to paracetamol. Flouroquinolones were involved in 3 (31%) cases followed by 2 (10%) cases due to ibuprofen and aspirin.…”

Section: Discussionmentioning

confidence: 99%

“…The results were similar in other studies. [14][15][16][17]20 Of the various types of adverse cutaneous drug reactions seen, maculopapular rash (38%) was the most common (38%) followed by urticaria (19%) and fixed drug eruptions (12%). These observations are in conformity with other studies.…”

Section: Discussionmentioning

confidence: 99%

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A study of adverse cutaneous drug reactions in the department of dermatology of a teaching hospital in Jamnagar, India

Dhanani

Sukhlecha

2017

Int J Basic Clin Pharmacol

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Background: Adverse drug reactions cause significant morbidity and mortality in health care set up. They are responsible for a significant number of hospital admissions. The data for adverse cutaneous drug reactions (ACDRs) is limited our country. Thus, the present study emphasises on the need of an effective adverse drug reaction reporting programme.Methods: A prospective study to assess the ACDRs in Dermatology department was conducted in a teaching hospital of India. Male to female ratio, most common class of drug, individual drugs causing ACDRs, common types of ACDRs were studied. Other parameters like causality assessment, preventability and seriousness of ACDRs were also studied.Results: A majority of the patients (38%) with ACDR were in the age group of 25-44 years followed by 45-64 years (31%). The rate of ACDRs was more in males (54%). The most frequent ACDR reported was maculopapular rash (38%), followed by urticaria (19%) and fixed drug eruptions (12%). Most of the reactions (93%) were bizarre/ unpredictable in nature. Amongst drug groups, antimicrobials (48%) were most frequently associated with ACDRs followed by NSAIDs (30%) and antiepileptics (12%). Most of the reactions (94%) were mild-moderate in nature. Only 9% of ACDRs reported in this study were preventable. Paracetamol was the most common offending drug followed by cotrimoxazole, ibuprofen, amoxicillin, phenytoin in decreasing order. Causality assessment found ACDRs in probable category (68%) using WHO-UMC criteria.Conclusions: It is important to monitor and report adverse drug reactions in order to promote safe and rational use of medicines.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A study of adverse cutaneous drug reactions in the department of dermatology of a teaching hospital in Jamnagar, India

Dhanani

Sukhlecha

2017

Int J Basic Clin Pharmacol

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Fixed Drug Eruption due to Fluconazole: Not so uncommon Now-a-days

Santra¹,

Pramanik

Raychaudhuri

2014

JCDR

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Sir,Fixed drug eruptions (FDEs) represent the most common cutaneous adverse drug reaction which is seen in the Indian scenario [1]. FDE is a distinctive drug-induced dermatosis with a characteristic recurrence at the same sites of the skin or mucous membrane, which occurs after repeated administrations of the causative drug [2].It was first described by Bourns in1889; five years later, it was termed by Brocq as "eruption erythemato-pigmentee fixee" [3]. The most common drugs which cause FDE are antibiotics, followed by nonsteroidal anti-inflammatory drugs (diclofenac, aspirin, naproxen, and ibuprofen) [2]. Fluconazole is one of the most common drugs which is used in dermatology practice.We are reporting an FDE which occurred secondary to fluconazole intake. A 22-year-old woman received five doses of fluconazole (150 mg) orally, once a month, for recurrent vaginal candidiasis. A red erythematous macule which measured approximately 2 (two) centimetres in diameter, with well-defined and raised margins, appeared on the medial side of her right popliteal fossa, that was associated with burning and itching, four hours after she had taken her second dose of fluconazole. It faded, but a violet pigmentation developed after a week. A month later, she again developed two macules of similar dimensions within four hours of intake of another fluconazole dose. One of the lesions developed on exactly the same site where another had developed in the earlier episode and the other developed in the left popliteal fossa. After one week, the patches faded and hyperpigmented areas developed on the affected areas.Our differential diagnosis included fixed drug eruption and erythema multiforme. Although fixed drug eruption is primarily a clinical diagnosis, we conducted an oral challenge test. An oral challenge test with fluconazole (150 mg) was conducted 4 weeks later and it showed similar signs, three hours after intake of the drug. A local provocation test was performed with 10% fluconazole in petrolatum on the left pigmented area and with 10% fluconazole in ethanol on the right pigmented area. For comparison, the same compounds were tested on normal skin of her back. After 15 hours, two red patches developed on both sides of her legs and none developed on her back. A skin biopsy specimen taken from the left popliteal area revealed a lichenoid infiltrate, a basal cell vacuolization, dermal melanophages and a superficial perivascular lymphocytic infiltrate, which were consistent with features of FDE. The drug was dechallenged and the patient was treated antihistaminics and steroids.Contrary to this case, most of the previous studies done on FDEs caused by drugs had demonstrated higher occurrences in men as compared to those seen in women [4]. In the previous studies, all female patients were prescribed fluconazole for vaginal candidiasis, while male patients were prescribed fluconazole for Candida balanitis [5]. Cross-reactions may occur with structurally related agents such as itraconazole [6]. In almost all the cases, eruptions had o...

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Evaluation of severe adverse cutaneous drug reactions in patients admitted to tertiary care center: A cross‐sectional study

Moshayedi,

Asilian,

Mokhtari

2024

Health Science Reports

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Background and AimsAdverse cutaneous drug reactions (ACDRs) are common and potentially life‐threatening, while also hindering patient compliance to medications. Given the regional differences in patterns and prevalence of ACDRs, it is important to study the epidemiology, as well as the clinical and outcome patterns of patients with ACDRs in Iran.MethodsThis cross‐sectional study on ACDRs was conducted among hospitalized patients in a referral university hospital in the city of Isfahan, Iran. The patients' demographics, clinical information, and outcomes, including age, gender, past medical history, medication history, drug reaction with eosinophilia and systemic symptoms (DRESS) diagnosis, Steven‐Johnson Syndrome (SJS) diagnosis, toxic epidermal necrosis (TEN) diagnosis, treatment regimen (steroids or intravenous immunoglobulin [IVIG]) and outcome information, including intensive care requirements, severe medical complications, or death, were obtained from medical records.ResultsA total of 195 patients with a mean age of 40 years and consisting of 61% females were included. Carbamazepine, lamotrigine, sodium valproate, and phenytoin are the most commonly reported medications. Rate of complications was 45% with DRESS, SJS, and TEN diagnosed in 26%, 47%, and 19%, respectively. Treatment was carried out with steroids and IVIG in 81% and 19%, respectively. Among patients, 15% required intensive care and 5% died. Diagnosis of TEN, older age, and baseline heart disease were predictors of mortality. Patients with SJS were younger and more likely to be males, and they were more likely to have eye complications. On the other hand, patients with the diagnosis of TEN were more likely to receive IVIG and intensive care, and had a higher mortality rate.ConclusionOur study provides insight into the demographics and clinical patterns of Iranian patients with ACDRs. This will help in predicting rates of complications, treatments, and outcomes in patients and therefore make proper management decisions.

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Clinical study of cutaneous drug eruptions in 200 patients

Abstract: Fixed drug eruption was the most common drug eruption seen. Cotrimoxazole was the most common cause of drug eruptions.

Cited by 76 publications

References 0 publications

A study of adverse cutaneous drug reactions in the department of dermatology of a teaching hospital in Jamnagar, India

A study of adverse cutaneous drug reactions in the department of dermatology of a teaching hospital in Jamnagar, India

Fixed Drug Eruption due to Fluconazole: Not so uncommon Now-a-days

Evaluation of severe adverse cutaneous drug reactions in patients admitted to tertiary care center: A cross‐sectional study

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