Cutaneous Adverse Drug Reactions Seen at a University Hospital Department of Dermatology

Abstract

Patients with suspected cutaneous adverse drug reactions are often referred to allergy clinics or departments of dermatology for evaluation. These patients are selected compared with patients identified in prospective and cross-sectional studies of hospital populations. This explains the observed variation in prevalence of specific reactions and of eliciting drugs. This study investigated the prevalence of cutaneous adverse drug reactions in a university hospital department of dermatology that is specially focused on allergy. An 8-month survey was carried out during the period April-December 2003. Consecutive patients suspected of having cutaneous adverse drug reactions during this period were examined by dermatologists and investigated. Drug imputability was assessed in the 194 patients included; 33.5% had an exanthema with certain or likely drug imputability. Urticaria and local reactions at injection sites were the most frequent reactions (25% and 18.8%, respectively). Beta-lactam antibiotics, extracts for desensitization and insulins were the main drug groups involved, and accounted for 22.8%, 17.1% and 14.2%, respectively, of the reactions. Extracts for desensitization and insulins elicited more reactions than expected. This probably reflects the referral pattern to an allergy clinic.

Clinical Profile of Cutaneous Adverse Drug Reactions in a Tertiary Care Centre

“…But certain other studies have reported a higher incidence, 2.6% in a study conducted in North India [5] and 1.5% and 1.38% respectively in some other studies [6,7].The lower incidence of cADR in our study may be due to the fact that being a tertiary care centre only doubtful and serious cases had attended our hospital. Some studies had reported a higher frequency in women [8,9] whereas some other studies have noticed higher occurrence in men [10,11].…”

An epidemiological and clinical analysis of cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia

“…[13] Few studies explored the rate of cADRs seen by a hospital dermatology department; cADRs accounted for 1.38% of all referrals to a university hospital department of dermatology in Denmark and 1.5% of total dermatology consultations seen at a hospital in Tunisia. [8,14] The lower rate of cADRs (0.86%) seen in our department was probably due to referral bias where only doubtful or serious cADRs were referred to us.…”

“…Most epidemiological studies analyzed the occurrence of cADRs in inpatients and revealed a wide variation in the prevalence rate which ranged from 0.36% to 12.2%. [5][6][7][8][9][10]12] A meta-analysis of 39 prospective studies from US hospitals showed that 15.1% of hospitalized patients had cADR. [13] Few studies explored the rate of cADRs seen by a hospital dermatology department; cADRs accounted for 1.38% of all referrals to a university hospital department of dermatology in Denmark and 1.5% of total dermatology consultations seen at a hospital in Tunisia.…”

“…[3] The prevalence, patterns of PMID: ***** cADR and their causative drugs vary greatly among the different populations previously studied in Europe, Israel, and Asia. [2][3][4][5][6][7][8][9] Although the majority of cADR are mild and self-limiting, severe cADR (SCAR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) are associated with significant morbidity and mortality. [10] The objective of this study is to (i) document the rate of cADR in our population, (ii) identify the clinical pattern of drug eruptions and the common drugs implicated, particularly in SCAR such as SJS/TEN and DRESS, and (iii) determine the outcome of patients with SCAR.…”

Full-Course Drug Challenge Test in the Diagnosis of Delayed Allergic Reactions to Penicillin

“…In our experience they are of little value in routine investigation of drug allergy [1,11]. Instead, patients are routinely instructed to contact the allergy clinic in case of delayed reactions to IDT and are questioned with regard to adverse reactions to skin tests when they return for the DCT or following the FC-DCT.…”