Severe Cutaneous adverse reactions in a local hospital setting in Bangladesh: a 5-year retrospective study
DOI:
https://doi.org/10.66344/jpad.v33i3.2325Keywords:
SCADRs, SJS, TEN, Anticonvulsant drugs, Drug eruptionAbstract
Bangladesh Cutaneous Adverse Drug Responses (CADR) are common adverse drug reactions that can manifest in many ways and range in severity. The most typical drug allergy symptom is skin manifestation, underscoring how crucial it is to identify the offending medication and stop using it doing so could even save your life in some cases.
Objective This study aims to investigate the incidence of severe and fatal cutaneous adverse medication reactions (SCAR) in hospitalized Bangladeshi patients and the prevalence of severe and fatal cutaneous adverse drug reactions (SCAR) in hospitalized patients.
Methods Inpatient records from the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, were used to gather data retroactively throughout the time frame of January 2012 to December 2016. Age, gender of the patients, implicated drugs, observed drug reactions, course of treatment, and results were some variables we examined (mortality and morbidity).
Results Clinical evaluation of the study participants revealed that 46% of cases were SJS, 29% were TEN, 16% were DRESS, and 10% were AGEP. The age range of 31 to 50 years saw the highest incidence (46%) of cases. Drug classes that contain anticonvulsants may have the highest incidence of SCADRs. Phenytoin caused 16% of patients' SCADRs, followed by carbamazepine in 22% of instances and phenobarbital in 14% of cases.
Conclusion SCADRs have been a serious issue in healthcare for decades. The majority of SCADR is caused by medications that doctors give. SCADRs were more frequently observed with anticonvulsants from the carbamazepine and phenytoin categories. Continuous monitoring of SCADRs is necessary to develop preventive measures.
References
1. Cho YT, Chu CY. Treatments for Severe Cutaneous Adverse Reactions. J Immunol Res. 2017;2017:1–9.
2. Su P, Aw CWD. Severe cutaneous adverse reactions in a local hospital setting: a 5-year retrospective study. Int J Dermatol. 2014;53(11):1339–45.
3. Dimri D. Retrospective Analysis of Pattern of Cutaneous Adverse Drug Reactions in Tertiary Hospital of Pauri Garhwal. J Clin Diagn Res. 2016;10(5):FC01–FC06.
4. Iffat Hasan, Konchock Dorjay, Parvaiz Anwar. Thalidomide in Dermatology: Revisited. Indian J Dermatol. 2015; 60(2):213.
5. Bates DW. Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention. JAMA. 1995;274(1):29-34.
6. Lazarou J, Pomeranz BH, Corey PN. Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies. JAMA. 1998;279(15):1200-5.
7. Szatkowski J, Schwartz RA. Acute generalized exanthematous pustulosis (AGEP): A review and update. J Am Acad Dermatol. 2015;73(5):843–8.
8. Nayak S, Acharjya B. Adverse cutaneous drug reaction. Indian J Dermatol. 2008;53(1):2-8.
9. Lin CC, Chen CB, Wang CW, Hung SI, Chung WH. Stevens-Johnson syndrome and toxic epidermal necrolysis: risk factors, causality assessment and potential prevention strategies. Expert Rev Clin Immunol. 2020;16(4):373–87.
10. Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (drug rash with eosinophilia and systemic symptoms: DRESS). Semin Cutan Med Surg. 1996;15(4):250–7.
11. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. 2007;156(3):609–11.
12. Ang CC, Wang YS, Yoosuff ELM, Tay YK. Retrospective analysis of drug-induced hypersensitivity syndrome: A study of 27 patients. J Am Acad Dermatol. 2010;63(2):219–27.
13. Coopman SA, Johnson RA, Platt R, Stern RS. Cutaneous Disease and Drug Reactions in HIV Infection. N Engl J Med. 1993;328(23):1670–4.
14. Patel RM, Marfatia YS. Clinical study of cutaneous drug eruptions in 200 patients. Indian J Dermatol Venereol Leprol. 2008;74(4):430.
15. Hasan R, Akhtar N, Begum M, Ali ME, Paul K, Zakaria A, et al. Cutaneous morphological patterns of adverse drug reactions: a study of 50 cases. J Pak Assoc Dermatol. 2010;20:206-11.
16. Sushma M, Noel MV, Ritika MC, James J, Guido S. Cutaneous adverse drug reactions: a 9-year study from a South Indian Hospital: Cutaneous adverse drug reactions. Pharmacoepidemiol Drug Saf. 2005; 14(8):567–70.
17. Zaraa I, Jones M, Trojjet S, Cheikh Rouhou R, El Euch D, Mokni M, et al. Severe adverse cutaneous drug eruptions: epidemiological and clinical features: Severe adverse cutaneous drug eruptions. Int J Dermatol. 2011;50(7):877–80.
18. Pudukadan D, Thappa DV. Adverse cutaneous drug reactions: Clinical pattern and causative agents in a tertiary care center in South India. Indian J Dermatol Venereol Leprol. 2004;70(1):20–4.
19. Lee H Y, Thirumoorthy T, Pang S M. Cutaneous adverse drug reactions in hospitalised patients. Singapore Med J. 2010;51(10):767.
20. Patel RM, Marfatia YS. Clinical study of cutaneous drug eruptions in 200 patients. Indian J Dermatol Venereol Leprol. 2008;74(4):430.
21. Criado PR, Criado RFJ, Vasconcellos C, Ramos R de O, Gonçalves AC. Reações cutâneas graves adversas a drogas - aspectos relevantes ao diagnóstico e ao tratamento - Parte I - Anafilaxia e reações anafilactóides, eritrodermias e o espectro clínico da síndrome de Stevens-Johnson & necrólise epidérmica tóxica (Doença de Lyell). An Bras Dermatol. 2004;79(4):471–88.
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