Severe cutaneous drug reactions in Guinean children: a monocentric retrospective study of 35 cases

Abstract

Background: Data on Severe cutaneous drug reactions (CADRs) are not common among in sub-Saharan Africa children. The purpose of this study was to document the clinical, etiological and evolutionary aspects of Severe CDRs in children hospitalized at the dermatology department of university hospitals of Conakry. Material and Methods: Retrospective study, conducted from 1 January 2000 to 31 December 2014. Were included all children aged 0-17 years hospitalized for severe CARDs. The data collected were Socio-demographic, clinical, para-clinical and evolution variables. The data was entered and analyzed using the Excel 8.0 software. Results: During a study period, 4437 patients of all ages was hospitalized in dermatology department. 35 patients were included with an average age of 11.3 years and a sex ratio of 1.5.The main clinical patterns were: Stevens Johnson syndrome 37.14% (13/35) Lyell syndrome 25.71 % and generalized bullous fixed eruption 22.85%. The drug was identified as 32 patients (91.42%): Sulfadoxine-Pyriméthamine 40.62%, cotrimoxazole 21.85%, nevirapin 12.5%, ampicillin 6.25%, traditional Pharmacopoeia 6.25% and griseofulin 3.12%. It was taken following self-medication in 14 patients, including a parental initiative in 9 patients. 7 patients had a history of drug allergy and 4 were HIV positive. We recorded 5 deaths. Conclusion: Our study confirms the rarity of severe CADRs in children. The importance of the sulfadoxine-pyrimethamine in the occurrence of severe CADRs in children is the particularity of our series.

Nursing Care of Stevens Johnson Syndrome and Toxic Epidermal Necrolysis: Case Study of Dermatology Unit of Referral Hospital, Kenya

“…Of the SJS patients 24 (55%) and it is worth noting that the mortalities were partly linked to HIV infection. As demonstrated in a recent, study in Africa, HIV positive patients were the majority among those seen with cutaneous adverse drug reactions and suggested a high mortality linked to HIV infection [27].…”

Severe Generalized Bullous Fixed Drug Eruption Treated with Cyclosporine: A Case Report and Literature Review

“…A further search (Fig. 3 ) revealed 21 published cases of the generalized bullous subtype in children [ 5 , 6 , 7 , 8 , 9 ]. Reports of non-generalized bullous eruptions were excluded.…”

“…Three others occurred secondary to cotrimoxazole, 3 to hyoscine butylbromide, 2 to sulphadoxine/pyrimethamine, 1 to erythromycin, and 1 to ampicillin. In 5 cases, the exact drug could not be identified [ 5 , 6 , 7 , 8 , 9 ].…”

“…Often, lesions are distributed on at least three of six different anatomic sites including the head and neck, anterior trunk, posterior trunk, upper extremities, lower extremities, and genitalia [ 4 ]. In reviewing the literature, there are very few published cases of generalized bullous FDEs (GBFDEs) in the paediatric population [ 5 , 6 , 7 , 8 , 9 ]. However, their extensive distribution and skin detachment warrants urgent assessment and management.…”

Fatal case of toxic epidermal necrolysis induced by ciproflfl oxacin in a child

“…La Nécrolyse Epidermique Toxique (NET) ou syndrome de Lyell fait partie avec le syndrome de Stevens-Johnson (SSJ) des toxidermies bulleuses sévères [1]. La différence majeure entre ces deux pathologies concerne l'extension des lésions de l'épidermolyse : moins de 10% pour le SJS, plus de 30% pour le NET et entre 10 et 30% en cas de « chevauchement » [2].…”