Clinicoepidemiological Profile of Severe Cutaneous Adverse Drug Reaction: A Retrospective Study

clinicoepidemiology severe CADR

Authors

  • Damayanti Damayanti
    dr_damayanti_bs@yahoo.com
    Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Menul Ayu Umborowati Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Sylvia Anggraeni Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Cita Rosita Sigit Prakoeswa Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Marsudi Hutomo Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Hari Sukanto Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital, Surabaya, Indonesia
April 4, 2019

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Background: Drug eruption were varied from mild to severe reaction. Few studies have assessed the severe cutaneous adverse drug reaction (SCADR), especially in the setting of general hospital. Purpose: To evaluate clinicoepidemiological profile of SCADR at Dermatology and Venereology Ward Dr. Soetomo Hospital, Surabaya, Indonesia. Methods: All SCADR patients at Dr. Soetomo Hospital, Surabaya, Indonesia in the period of January 2016 – June 2017 was evaluated. Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Acute Generalized Exanthematous Pustulosis (AGEP), Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and exfoliative dermatitis cases were included in the study. Results: There were 24 patients in this study, consisted of 11 SJS cases, 1 TEN case, 2 SJS/TEN-overlap cases, 10 exfoliative dermatitis cases. The mean of latent period between drug intake and onset of symptoms was 15.8 days. The most common offending drug was mefenamic acid (20.9%), followed by cefadroxil and phenytoin (each 16.7%). Antibiotics was the highest frequent offending drug-groups (62.5%), followed by non-steroid anti-inflammatory drugs (NSAIDs). Prompt withdrawal of the offending drugs, systemic corticosteroid, and supported therapy were given to all patients, which gave good results in 21/24 patients (87.5%). Conclusion: Antibiotics were the most common offending drug-groups. SCADR might give high mortality rate, but early diagnosis, prompt withdrawal of the suspected drugs, closed monitoring to evaluate complications can improve the prognosis of SCADR.

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