Drug-induced erythroderma in patients with acquired immunodeficiency syndrome.

Acquired immunodeficiency syndrome Drug eruption Erythroderma Modified severity-of-illness score for toxic epidermal necrolysis

Journal

World journal of emergency medicine
ISSN: 1920-8642
Titre abrégé: World J Emerg Med
Pays: China
ID NLM: 101549691

Informations de publication

Date de publication:
2021
Historique:
received: 10 02 2021
accepted: 08 07 2021
entrez: 13 9 2021
pubmed: 14 9 2021
medline: 14 9 2021
Statut: ppublish

Résumé

To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome (AIDS) complicated with drug-induced erythroderma. The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis (SCORTEN) scores, and disease outcome spectrums were analyzed. Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin (IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%. The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.

Sections du résumé

BACKGROUND BACKGROUND
To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome (AIDS) complicated with drug-induced erythroderma.
METHODS METHODS
The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis (SCORTEN) scores, and disease outcome spectrums were analyzed.
RESULTS RESULTS
Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin (IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%.
CONCLUSIONS CONCLUSIONS
The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.

Identifiants

pubmed: 34512827
doi: 10.5847/wjem.j.1920-8642.2021.04.008
pii: WJEM-12-299
pmc: PMC8390352
doi:

Types de publication

Journal Article

Langues

eng

Pagination

299-302

Informations de copyright

Copyright: © World Journal of Emergency Medicine.

Déclaration de conflit d'intérêts

Conflicts of interests: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Auteurs

Wei-Fang Zhu (WF)

Department of Dermatology, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.

De-Ren Fang (DR)

Department of Dermatology, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.

Hong Fang (H)

Department of Dermatology, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.

Classifications MeSH