Severe Cutaneous Adverse Drug Reactions: A Study of 216 Patients from Udon Thani Hospital
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Abstract
Severe cutaneous adverse drug reactions (SCARs) are rare adverse reactions; however, these reactions are life-threatening. This study was a survey study from medical records of patients diagnosed with SCARs including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) who underwent treatment at Udon Thani Hospital during 2008-2019. The aims of this study were to investigate the causative drugs and the types of SCARs as well as the outcomes of SCARs in this patient group. Results from the study revealed that a total of 216 patients were diagnosed with SCARs, which consisted of 107 SJS patients, 15 TEN patients, 4 SJS/TEN patients, 74 DRESS patients, and 16 patients with other types of SCARs. Among them, 56.0% were males. The mean age of SCARs patients was 51.8±17.4 years. The most common causative drugs of SCARs were anticonvulsants (44.9%), followed by antibiotics (25.9%), allopurinol (16.7%), non-steroidal anti-inflammatory drugs (4.2%) and anti-tuberculosis drugs (3.7%). The mean onset of SCARs was 21.7±16.8 days (range 1-103 days). An average duration of hospitalization was 12.6±14.4 days with the median cost of treatment of 9,150 baht (range 500-207,718 baht). The mortality rate of SCARs was 2.8%. This large cohort study revealed the information regarding the list of causative drugs and the outcome of SCARs in a Thai population.
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