Common adverse cutaneous drug reaction patterns and the causative drugs in Malaysia

Abstract

Background:Patients with adverse cutaneous drug reactions (ACDRs) are frequently referred from primary care to tertiary centres for further management. This causes a loss of information regarding ACDRs as these patients discontinue primary care follow-up upon referral to tertiary care. The aim of this study is to determine the prevalence and characteristics of ACDR, and to use this valuable information to enhance awareness of primary care physicians regarding this condition. Method: A retrospective cross-sectional study on ACDR was done at the Dermatology Clinic, Kuala Lumpur General Hospital from January 2009 to December 2010. Results: The prevalence of ACDR was 0.2%. The majority of patients (71.6%) were below 59 years of age. ACDR commonly (55.2%) occurs within hours to days of drug ingestion and is of mild to moderate severity (74.6%). About 27.6% of affected patients took 1 to 5 drugs concurrently. Common cutaneous manifestation of ACDR includes maculopapular rash (22.4%) and Stevens-Johnson syndrome (SJS, 9.7%). Antibiotics (36.6%), traditional and complementary medicine (TCM, 17.9%) and analgesics (13.4%) were the most frequent agents responsible for ACDR. Conclusion:The prevalence of ACDR in this study is low and the majority were of mild to moderate severity. The most common cutaneous manifestation was a maculopapular reaction and Stevens-Johnson syndrome. Antibiotics were the commonest causative agent for ACDR followed by traditional and complementary medicine and analgesics. Patients presenting with cutaneous disorders in primary care should be assessed for possible ACDR. A detailed drug history, time of initiation and duration of drug consumption are all valuable information required for an accurate diagnosis and proper evaluation of ACDR. It is hoped that the findings of this study will facilitate early recognition of ACDR followed by identification and elimination of any possible offending drugs that may be prescribed in primary care practice.

Characteristics and Factors Associated with Adverse Cutaneous Drug Reactions Caused by Traditional, Complementary and Conventional Medicine in Malaysia

“…The current study showed a high prevalence of ACDR to TCM and it was the second most common cause after antibiotics. The details of the data from this cohort pertaining to ACDR secondary to conventional medicine (Talib et al 2015). Earlier studies also found that herbal medicines were a common cause for ACDR causing reactions similar to those with conventional medicine (Sudershan et al 2014;Li & Ma 2006 Majority of those affected by ACDRs to TCM and conventional medicine were from the Malay ethnic group.…”

Pattern of Adverse Cutaneous Drug Reactions (ACDR) to Systemic Drugs

“…Youngest patient was 2 years age and oldest one was 74. is is in accordance with previous studies. [12][13] People of advanced age need to take more daily medications and incidence adverse drug reactions are more among them. 14 Some studies found lower age groups as common su erer.…”

Clinical Profile of Severe Cutaneous Drug Eruptions in a Tertiary Care Hospital

“…The commonest manifestations of ACDR include maculopapular rash in 30 (22.4%) cases followed by SJS in 13 (9.7%) cases. 10 There are not many previous studies that looked at the relationship between duration of drug intake and onset of ACDR. Our study showed duration of reactions after the intake of drugs ranged from immediately within five minutes to six weeks after with a mean duration of 10.16 days.…”