Publication:

The current trend of cutaneous drug reactions at a tertiary care hospital

Background Cutaneous adverse drug reactions (CADR) are common yet important entity in dermatological clinical practice. This study is to investigate the clinical spectrum of CADR reactions and assess its causality relationship to offending drug.

Methods It was a cross-sectional observational study, conducted at a tertiary care hospital over a period of two years. Total of 200 patients with cutaneous drug rash diagnosed based on detailed history, correlation between drug intake and the onset of rash, thorough clinical examination and laboratory parameters were included and patients without details of drugs were excluded.

Results Among 200 cases, mean age was 33.57 years (6 months to 87 years). The commonest age group was 19-30 years (27%) and Male: female ratio was 0.94:1. The most common morphological pattern was maculopapular rash seen in 46 cases (23%), followed by FDE- 34 (17%), urticaria- 22 (11%), acneiform eruptions- 20 (10%), drug induced hyperpigmentation- 13 (6.5%), EMF- 12 (6%), lichenoid eruptions- 12 (6%), photosensitivity- 11 (5.5%), eczematous dermatitis- 6 (3%), pruritus- 6 (3%), angioedema- 6 (3%) and SJS- 6 (3%), DRESS- 2 (1%), TEN- 2 (1%), DHS and psoriasiform dermatitis in 1 each (0.5%) respectively. The most common drug was analgesics (31.2%), followed by anti-microbials (26.25%), corticosteroids (8.75%), antiepileptics (7.5%), anti-leprosy drugs (7.5%), anti-retroviral drugs (6.87%), antitubercular drugs (3.75%) and other drugs (8.12%).

Conclusions Many dermatological conditions can be induced, imitated or aggravated by drugs hence it is necessary for the health care system to promote periodic reporting to regional pharmacovigilance centres to ensure drug safety for clinician’s awareness.