Cutaneous drug reactions in human immunodeficiency virus infection

Coopman, Serge A.

doi:10.1001/archderm.127.5.714

Cited by 16 publications

(7 citation statements)

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“…Saiag et al also have reported cases with HIV infection. 15,16 This may be because of the following reasons that they are frequently exposed to various drugs, the viral infection sensitizing the patients to certain drugs, systemic glutathione deficiency and reduced ability to scavenge drug metabolites.…”

Section: Discussionmentioning

confidence: 99%

A clinical study of Stevens-Johnson syndrome and toxic epidermal necrolysis in a tertiary centre, South India

et al. 2017

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Background: Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered as the severest end of spectrum of erythema multiforme. Various etiologies like infections, drugs and malignancies have been proposed. The aim of the present study was to know the incidence, common causes, clinical course of SJS and TEN and to estimate the morbidity and mortality.Methods: A 2 year study of patients presenting with SJS and TEN was carried out. A detailed examination to know the cutaneous and mucosal involvement was done. Biopsy was done in 3 patients.Results: There were fifty patients of SJS-TEN spectrum. Of which 31 were SJS, 3 had SJS-TEN overlap and 16 had TEN. Anticonvulsants were implicated in causing these reactions in 24 patients (48%) with carbamazepine being the most common i.e. in 16 patients (32%). Sparing of pressure areas like the strap area of brassier and waist was noticed in two patients (4%). The most common complication was due to eye involvement seen in 20 patients (40%). 46 patients were treated with steroids and of the remaining, 3 were children and one was HIV positive. Only three patients with TEN (6%) died. Conclusions: To conclude, TEN was less common than SJS, had more sequelae and more mortality compared to SJS.

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Section: Discussionmentioning

confidence: 99%

A clinical study of Stevens-Johnson syndrome and toxic epidermal necrolysis in a tertiary centre, South India

et al. 2017

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“…patients, who often are on multiple medications [22]. Scabies always has to be excluded when a patient complains about itch.…”

Section: Scabiesmentioning

confidence: 99%

AIDS and itch

Hulsebosch

1992

Acad Dermatol Venereol

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The complaint of itch is common in patients with AIDS and HIV infection. Inspection of the skin often reveals a dermatosis, but precise diagnosis is not always easy which makes it difficult for effective treatment. In HIV-positive patients with itch, as well as common dermatoses, one often has to deal with atypical and even new skin diseases. Many of these are papular, papulo-vesicular or papulo-pustular. This article is a protocol for the diagnosis and treatment of itch in these patients.

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“…Studies have established that HIV-positive individuals are a hundred times more susceptible to drug reactions than the general population, and advanced immunodeficiency portends an even greater risk [1]. Multiple heterogeneous factors are responsible for the substantial risk in HIV, including polypharmacy, slow acetylator status, relative glutathione deficiency, CD4+ T-cell counts of <200 cells/mm 3 or >25 cells/mm 3 [2], latent cytomegalovirus and Epstein-Barr virus infections [3] and high CD8+ T-cell counts >460 cells/mm 3 .…”

Section: Introductionmentioning

confidence: 99%

An Update on Adverse Cutaneous Drug Reactions in HIV/AIDS

et al. 2019

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Background: The global mortality from HIV and the cutaneous burden of infective, inflammatory and malignant diseases in the setting of AIDS have significantly declined following the advent of highly active antiretroviral therapy. Regrettably, there has been a contemporaneous escalation in the incidence of adverse cutaneous drug reactions (ACDR), with studies attesting that HIV-positive individuals are a hundred times more susceptible to drug reactions than the general population, and advanced immunodeficiency portending an even greater risk. Several variables are accountable for this amplified risk in HIV. Summary: Adverse reactions to trimethoprim-sulfamethoxazole are the most common, increasing from approximately 2–8% in the general population over to 43% amongst HIV-positive individuals to approximately 69% in subjects with AIDS. Antituberculosis drugs and antiretrovirals are also well-known instigators of ACDR. Cutaneous reactions range from mild morbilliform eruptions to severe, life-threatening manifestations in the form of Stevens-Johnson syndrome/toxic epidermal necrolysis. Histological features vary from vacuolar interface changes to full-thickness epidermal necrosis with subepidermal blister formation. A precipitous diagnosis of the ACDR, clinically and histologically if necessary, together with the isolation of the causative drug is critical. The identification process, however, is often complex and multifaceted due to polypharmacy and inconclusive data on which drugs are the most likely offending agents, especially against the background of tuberculosis co-infection. Key Messages: Whilst milder cutaneous reactions are treated symptomatically, severe reactions mandate immediate treatment discontinuation without rechallenge. Further studies are required to establish safe rechallenge guidelines in resource-limited settings with a high HIV and tuberculosis prevalence.

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Cutaneous drug reactions in human immunodeficiency virus infection

Cited by 16 publications

References 0 publications

A clinical study of Stevens-Johnson syndrome and toxic epidermal necrolysis in a tertiary centre, South India

A clinical study of Stevens-Johnson syndrome and toxic epidermal necrolysis in a tertiary centre, South India

AIDS and itch

An Update on Adverse Cutaneous Drug Reactions in HIV/AIDS

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