Drug-induced skin reactions: a 2-year study

Mahmood Farshchian, Akram Ansar, Abbas Zamanian, Ghasem Rahmatpour-Rokni, Arash Kimyai-Asadi, Mehdi Farshchian, Mahmood Farshchian, Akram Ansar, Abbas Zamanian, Ghasem Rahmatpour-Rokni, Arash Kimyai-Asadi, Mehdi Farshchian

Abstract

Background: The aim of this study was to analyze the clinical characteristics of patients with adverse cutaneous drug reactions, which occur when a medicinal product results in cutaneous morbidity.

Methods: The study included 308 patients who were diagnosed as having an adverse cutaneous drug reaction during the study period (2007-2009). In 84 cases, histopathologic examination of skin biopsies were also performed.

Results: Patients with drug reactions were found to be more commonly female (63%) than male (37%). Beta-lactam antibiotics were found to be the most frequent cause of adverse cutaneous drug reactions (42.7%), followed by non-steroidal anti-inflammatory drugs (16.5%). Acute urticaria was the most common clinical presentation (59.2%) followed by fixed drug eruptions (18.5%), and maculopapular eruptions (14.9%).

Conclusion: Adverse cutaneous drug reactions in our study population were mainly induced by beta-lactam antibiotics and non-steroidal anti-inflammatory drugs. The most common forms of cutaneous adverse drug reactions were found to be acute urticaria, fixed drug eruptions, and maculopapular rashes.

Keywords: acute urticaria; adverse drug reaction; exanthematous eruption.

Figures

Figure 1
Figure 1
A 25-year-old woman with the diagnosis of acute generalized exanthematous pustulosis following the use of cephalexin.
Figure 2
Figure 2
A 37-year-old woman with clinical manifestation of DRESS syndrome due to phenytoin. Abbreviation: DRESS, Drug Reaction with Eosinophilia and Systemic Symptoms.
Figure 3
Figure 3
Causative agents for the three most common types of cutaneous drug reactions: urticaria, fixed drug eruptions, and maculopapular eruptions. Abbreviation: NSAIDs, non-steroidal anti-inflammatory drugs.

References

    1. Hunzicker T, Kazia P, Braunschweig S, et al. Comprehensive hospital drug monitoring (CHDM): Adverse skin reaction a 20 year survey. Allergy. 1997;52(4):388–393.
    1. Jean Revu Z, Allanore LV. Drug Reaction. In: Bolognia Jean L, Jorizzo Joseph L, Julie, et al., editors. Dermatology. 3rd ed. Elsevier; 2012. p. 335.
    1. Charli-Joseph Y, Cruz-Fuentes C, Orozco-Topete R. Incidence of adverse cutaneous drug reaction in Mexican sample: an exploratory study on their association to tumour necrosis factor alpha TNF2 allele. J Eur Acad Dermatol Venereol. 2009;23(7):788–792.
    1. Wolf R, Orion E, Marcos B, Matz H. Life-threatening acute adverse cutaneous drug reactions. Clin Dermatol. 2005;23(2):171–181.
    1. Pichler WJ, Yawalkar N, Britschgi M, et al. Cellular and molecular pathophysiology of cutaneous drug reaction. Am J Clin Dermatol. 2002;3(4):299–238.
    1. Hamilton RG, Adkinson NF., Jr Clinical laboratory assessment of IgE-dependent hypersensitivity. J Allergy Clin Immunol. 2003;111(2 Suppl):S687–S701.
    1. Kimyai-Asadi A, Harris JC, Nousari HC. Critical overview: adverse cutaneous reactions to psychotropic medications. J Clin Psychiatry. 1999;60(10):714–725.
    1. Sushma M, Noel MV, Ritika MC, James J, Guido S. Cutaneous adverse cutaneous drug: a 9 year study from a South Indian Hospital. Pharmacoepidemiology Drug Saf. 2005;14(8):567–570.
    1. Revuz J, Valeyrie-Allanore L. Drug reactions. In: Bolognia JL, Lorizzo JL, Rapini RP, editors. Dermatology. 2nd ed. Spain: Mosby-Elsevier; 2008. pp. 301–320.
    1. Roujean JC. Epidemiology of drug reaction, service de dermatologie, Universite Paris. 2004;13:322–328.
    1. Kacalak-Rzepka A, Klimowicz A, Bielecka-Grzela S, Załuga E, Maleszka R, Fabiańczyk H. Retrospective analysis of adverse cutaneous drug reactions in patients. Ann Acad Med Stetin. 2008;54(2):52–58.
    1. Souissi A, Fenniche S, Benmously R, Ben JS, Marrak H, Mokhtar I. Study of the cutaneous drugs reactions in a teaching hospital in Tunis. Tunis Med. 2007;85(12):1011–1015.
    1. Fiszenson-Albala F, Auzerie V, Mahe E, et al. A 6 month prospective survey of cutaneous drug reaction. Br J Dermatol. 2003;149(5):1018–1022.
    1. Justiniano H, Berlingeri-Ramos AC, Sanchez JL. Pattern analysis of drug-induced skin disease. Am J Dermatopathol. 2008;30(4):352–369.

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