Severe Cutaneous Adverse Reactions: A Single-Center Retrospective Study of 173 Patients in China.
Acute generalized exanthematous pustulosis
Drug reaction with eosinophilia and systemic symptoms
Stevens-Johnson syndrome
Systemic corticosteroids treatment
Toxic epidermal necrolysis
Journal
Annals of dermatology
ISSN: 2005-3894
Titre abrégé: Ann Dermatol
Pays: Korea (South)
ID NLM: 8916577
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
30
05
2019
revised:
09
07
2019
accepted:
15
07
2019
entrez:
29
4
2021
pubmed:
1
10
2019
medline:
1
10
2019
Statut:
ppublish
Résumé
Severe cutaneous adverse reactions (SCAR) to drugs are a crucial public health issue and the use of systemic corticosteroids in SCAR has been controversial. To analyze clinical features, causative drugs, treatment, outcomes, and prognostic factors of SCAR in the case-series of 173 patients, and add more information to the debate of using systemic corticosteroids in SCAR management. A retrospective study of 173 SCAR patients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) or acute generalized exanthematous pustulosis (AGEP) at a tertiary care institution in China between January 2014 and December 2017 was conducted. Of 173 patients, allopurinol, carbamazepine, and antibiotics are the most frequently implicated drugs for DRESS (40.4%), SJS/TEN (26.0%), and AGEP (40.0%) respectively. Moreover, there is a strongly negative correlation between early corticosteroids use and the progression ( Prompt short-course systemic corticosteroids use is associated with early-stage skin lesions remission without influencing the disease mortality. Lymphadenopathy and eosinophilia were the independent poor prognostic factors of SCAR.
Sections du résumé
BACKGROUND
BACKGROUND
Severe cutaneous adverse reactions (SCAR) to drugs are a crucial public health issue and the use of systemic corticosteroids in SCAR has been controversial.
OBJECTIVE
OBJECTIVE
To analyze clinical features, causative drugs, treatment, outcomes, and prognostic factors of SCAR in the case-series of 173 patients, and add more information to the debate of using systemic corticosteroids in SCAR management.
METHODS
METHODS
A retrospective study of 173 SCAR patients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) or acute generalized exanthematous pustulosis (AGEP) at a tertiary care institution in China between January 2014 and December 2017 was conducted.
RESULTS
RESULTS
Of 173 patients, allopurinol, carbamazepine, and antibiotics are the most frequently implicated drugs for DRESS (40.4%), SJS/TEN (26.0%), and AGEP (40.0%) respectively. Moreover, there is a strongly negative correlation between early corticosteroids use and the progression (
CONCLUSION
CONCLUSIONS
Prompt short-course systemic corticosteroids use is associated with early-stage skin lesions remission without influencing the disease mortality. Lymphadenopathy and eosinophilia were the independent poor prognostic factors of SCAR.
Identifiants
pubmed: 33911647
doi: 10.5021/ad.2019.31.5.545
pmc: PMC7992557
doi:
Types de publication
Journal Article
Langues
eng
Pagination
545-554Informations de copyright
Copyright © 2019 The Korean Dermatological Association and The Korean Society for Investigative Dermatology.
Déclaration de conflit d'intérêts
CONFLICTS OF INTEREST: The authors have nothing to disclose.
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