Severe cutaneous adverse reactions to drugs

Duong, Tu Anh; Valeyrie‐Allanore, Laurence; Wolkenstein, Pierre; Chosidow, Olivier

doi:10.1016/s0140-6736(16)30378-6

Cited by 352 publications

(434 citation statements)

References 137 publications

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“…It typically occurs in adults between the ages of 20 and 40, and is generally a post infectious disease. 3 Herpes simplex virus is the most frequent triggering agent of erythema multiforme flare ups, resulting in recurrences in 40% of patients. 4 Herpes simplex virus DNA has been detected in skin biopsies of recurrent erythema multiforme, even in the absence of clinical herpes flare-ups, suggesting that some cases of idiopathic erythema multiforme could be related to a subclinical herpes simplex virus infection.…”

Section: Discussionmentioning

confidence: 99%

“…3 Previous episodes of oral ulcers, sometimes with laryngitis and conjunctivitis, are indicative of erythema multiforme. Some 40% of people with erythema multiforme experience multiple recurrences, especially where the condition is triggered by herpes simplex virus.…”

Section: Discussionmentioning

confidence: 99%

“…Further specification of this timeline should include the half-lives of the causative drug(s), the patient's renal and hepatic function, and whether it is the first time the patient has taken the drug. 3 Reactions other than Stevens-Johnson syndrome and toxic epidermal necrolysis, for example, eosinophilia and systemic symptoms and acute generalised exanthematic pustulosis, are summarised in table 2⇓. 3…”

Section: Discussionmentioning

confidence: 99%

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The diagnosis is in the rings

Ingen‐Housz‐Oro¹,

Ortonne

Chosidow³

2017

BMJ

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The diagnosis is in the rings

Ingen‐Housz‐Oro¹,

Ortonne

Chosidow³

2017

BMJ

Self Cite

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“…1 EM must be distinguished from Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are drug induced in most cases. [2][3][4][5] However, mucous membrane (MM) lesions of EM major (EMM) are clinically similar to those of SJS/TEN and literature remains confusing between both diseases. Although well-described in SJS/TEN, 3,6 long-term sequelae of EMM are not very well-known.…”

Section: Editormentioning

confidence: 99%

“…2 Inositol signalling pathways are involved in intracellular calcium release, membrane trafficking, chemotaxis, ion channel activity and many other nuclear functions. 3 Inositol signalling is highly conserved throughout the animal kingdom and plays a key role in gene regulation. We hypothesized that, like cutaneous SCC, INPP5A expression will be decreased in OPSCC and that further reduction of INPP5A will occur with the transition from primary to metastatic disease.…”

Section: Editormentioning

confidence: 99%

Severe sequelae of erythema multiforme: three cases

Viarnaud¹,

Ingen‐Housz‐Oro

Marque

et al. 2017

Acad Dermatol Venereol

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Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

Lee,

Gomes,

Drucker

et al. 2024

JAMA

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ImportanceSerious cutaneous adverse drug reactions (cADRs) are potentially life-threatening drug hypersensitivity reactions involving the skin and internal organs. Antibiotics are a recognized cause of these reactions, but no studies have compared relative risks across antibiotic classes.ObjectivesTo explore the risk of serious cADRs associated with commonly prescribed oral antibiotics, and to characterize outcomes of patients hospitalized for them.Design, Setting, and ParticipantsNested case-control study using population-based linked administrative datasets among adults aged 66 years or older who received at least 1 oral antibiotic between 2002 and 2022 in Ontario, Canada. Cases were those who had an emergency department (ED) visit or hospitalization for serious cADRs within 60 days of the prescription, and each case was matched with up to 4 controls who did not.ExposureVarious classes of oral antibiotics.Main Outcomes and MeasuresConditional logistic regression estimate of the association between different classes of oral antibiotics and serious cADRs, using macrolides as the reference group.ResultsDuring the 20-year study period, we identified 21 758 older adults (median age, 75 years; 64.1% female) who had an ED visit or hospitalization for serious cADRs following antibiotic therapy and 87 025 matched controls who did not. In the primary analysis, sulfonamide antibiotics (adjusted odds ratio [aOR], 2.9; 95% CI, 2.7-3.1) and cephalosporins (aOR, 2.6; 95% CI, 2.5-2.8) were most strongly associated with serious cADRs relative to macrolides. Additional associations were evident with nitrofurantoin (aOR, 2.2; 95% CI, 2.1-2.4), penicillins (aOR, 1.4; 95% CI, 1.3-1.5), and fluoroquinolones (aOR, 1.3; 95% CI, 1.2-1.4). The crude rate of ED visits or hospitalization for cADRs was highest for cephalosporins (4.92 per 1000 prescriptions; 95% CI, 4.86-4.99) and sulfonamide antibiotics (3.22 per 1000 prescriptions; 95% CI, 3.15-3.28). Among the 2852 case patients hospitalized for cADRs, the median length of stay was 6 days (IQR, 3-13 days), 9.6% required transfer to a critical care unit, and 5.3% died in the hospital.Conclusion and RelevanceCommonly prescribed oral antibiotics are associated with an increased risk of serious cADRs compared with macrolides, with sulfonamides and cephalosporins carrying the highest risk. Prescribers should preferentially use lower-risk antibiotics when clinically appropriate.

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Severe cutaneous adverse reactions to drugs

Cited by 352 publications

References 137 publications

The diagnosis is in the rings

The diagnosis is in the rings

Severe sequelae of erythema multiforme: three cases

Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

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