Cutaneous Reactions to Alimentary Tract Medications: Results of a Seven-Year Surveillance Program and Review of the Literature

Aims Cutaneous manifestations are frequently reported in association with drug use. The aim of this study was to analyse the skin reactions reported to the spontaneous surveillance systems of four Italian regions (Friuli Venezia Giulia, Lombardy, Sicily and the Veneto), and correlate the reports with estimated drug consumption during the same period, paying particular attention to the reactions to antimicrobial agents and nonsteroidal anti-inflammatory drugs (NSAIDs). Methods All of the adverse drug reactions (ADRs) reported spontaneously between January 1996 and December 1997 to the surveillance systems of four Italian regions (a total population of about 20 million people) were analysed by a panel of experts including dermatologists. On the basis of the Critical Term List of the World Health Organization (WHO), the reactions were classified as either serious or nonserious events. Drug consumption was expressed as a daily defined dose (DDD)/1000 inhabitants/day. Results A total of 2224 adverse skin reaction reports (44.7% of all of the reported ADRs) were identified, making a reporting rate of about 5.5 per 100 000 inhabitants/year. The female/male ratio was 1.58, and the reporting rate progressively increased with age. The drug categories with the highest number of cutaneous reactions were antimicrobials, followed by NSAIDs, analgesics and radiology contrast media. There was a total of 372 (16.9%) serious reaction reports, the most frequent being angioedema (171 cases), erythema multiforme (68 cases) and photosensitivity (37 cases). Co-trimoxazole, followed by the cephalosporins and fluoroquinolones, were associated with the highest consumption-related reporting rate among the antimicrobials, and aspirin and dipyrone among the NSAIDs and analgesics. Conclusions Spontaneous reports from four Italian regions revealed that the skin was the organ most frequently affected by ADRs. The paper shows the validity of a regional decentralized system in Italy. health service use and costs [4, 6]. Keywords

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Cutaneous reactions to drugs. An analysis of spontaneous reports in four Italian regions

Naldi

Conforti

Venegoni

et al. 1999

Brit J Clinical Pharma

160

118

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Retrospective Analysis of Drug-Induced Urticaria and Angioedema: A Survey of 2287 Patients

Nettis

Marcandrea

Maggio

et al. 2001

Immunopharmacology and Immunotoxicology

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Urticaria and angioedema (UA) represent a syndrome that is frequently encountered in children and adults. However, although they are often associated (in up to 50% of some patient populations), these two clinical entities should not be considered synonymous because they have distinct clinical and histopathological characteristics. The frequency of UA in drug-induced pathologies is quite high Here we report a retrospective survey of 2287 patients, observed between 1988 and 1997 presenting one or more episodes of drug-induced UA. In 1,973 patients (86.2%) [639 (32.4%) males and 1,334 (67.6%) females] a specific drug responsible for UA was identified. Particularly over the last two years the frequency of drug-induced UA has tended to increase, being more prevalent in females and the majority of cases (576: 23.1%) occuring during the third decade of life. The most frequently involved drugs are anti-inflammatory (particularly acetylsalicylic acid) and antimicrobial agents (mainly beta-lactams).

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Drug points: Lichenoid drug eruption with proton pump inhibitors

Bong

Lücke²,

Douglas³

2000

BMJ

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examinations or when the examination was performed (data not shown). Twenty nine of the children with myeloid leukaemia and 27 of the controls had been exposed to ultrasound prenatally (odds ratio 1.0; 0.42 to 2.40) (table). The risk of myeloid leukemia was not influenced by the number of ultrasound examinations (table). A slightly higher, but not significant, risk was seen for those examined during the second trimester (odds ratio 1.42; 0.88 to 2.29). Adjustments for potential confounding, such as maternal age, high birth weight, and twin pregnancies, did not alter the results (data not shown).

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Cutaneous Reactions to Alimentary Tract Medications: Results of a Seven-Year Surveillance Program and Review of the Literature

Cited by 3 publications

References 20 publications

Cutaneous reactions to drugs. An analysis of spontaneous reports in four Italian regions

Cutaneous reactions to drugs. An analysis of spontaneous reports in four Italian regions

Retrospective Analysis of Drug-Induced Urticaria and Angioedema: A Survey of 2287 Patients

Drug points: Lichenoid drug eruption with proton pump inhibitors

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