A clinical analysis of 48 cases of severe drug eruption_West China Medical Journal

Authors：

 WANG Lu , CHEN Huaquan , ZHANG Zheng

Department of Dermatology, the People’s Hospital of Deyang, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

WANG Lu, Email: wanglu19850810@126.com

Keywords：

Severe drug eruption; Clinical analysis; Pathogenesis

DOI：

10.7507/1002-0179.201510122

Video：

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Objective To explore the clinical features and prognosis related factors of severe drug eruption. Methods The clinical data of 48 patients with drug eruption treated between January 2010 and August 2015 were retrospectively analyzed. Results The major type of drug eruption was Stevens-Johnson syndrome (58.3%), followed by toxic epidermal necrolysis (TEN) (27.1%) and hypersensitivity syndrome (14.6%). The major allergenic drug which might cuase drug eruption was antimicrobial agent (25.0%), followed by antipyretic analgesic drug (22.9%) and antigout drug (18.8%). Carbamazepine and allopurino were the common drugs caused TEN. Conclusion It is important to give sufficient corticosteroid earlier combined with intravenous immunoglobulin for reducing mortalities of severe drug eruption.

Citation： WANG Lu, CHEN Huaquan, ZHANG Zheng. A clinical analysis of 48 cases of severe drug eruption. West China Medical Journal, 2017, 32(6): 871-874. doi: 10.7507/1002-0179.201510122 Copy

1.	Li LF, Ma C. Epidemiological study of severe cutaneous adverse drug reactions in a city district of China. Clin Exp Dermatol, 2006, 31(5): 642-647.
2.	Lee HY, Chung WH. Toxic epidermal necrolysis: the year in review. Curr Opin Allergy Clin Immunol, 2013, 13(4): 330-336.
3.	Kardaun SH, Mockenhaupt M, Roujeau JC. Comments on: DRESS syndrome. J Am Acad Dermatol, 2014, 71(5): 1000-1000. e2.
4.	Lissia M, Mulas P, Bulla A, et al. Toxic epidermal necrolysis (Lyell’S disease). Bums, 2010, 36(2): 152-163.
5.	池泽善郎. DIHS及SJS/TEN重症药疹的治疗, 日本医学介绍, 2004, 25(2), 74-75.
6.	Kito Y, Ito T, Tokura Y, et al. High-dose intravenous immunoglobulin monotherapy for drug-induced hypersensitivity syndrome. Acta Derm Venereol, 2012, 92(1): 100-101.
7.	钟华, 王欢, 牛军, 等. 547 例皮肤药物不良反应回顾性分析. 中华医学会 2011 年全国变态反应学术会议论文集. 2011, 79(1): 52-56.
8.	Riyaz N, Sarita S, Arunkumar G, et al. Drug-induced hypersensitivity syndrome with human herpesvirus-6 reactivation. Indian J Dermatol Venereol Leprol, 2012, 78(2): 175-177.
9.	王国恩, 张晓玲, 刘敏龙, 等. 中毒性表皮松解型药疹 20 例疗效分析. 中国皮肤性病学杂志, 2016, 30(5): 37-39.
10.	焦乾升, 黄忠华, 方卫利, 等. 2013 年第四季度我院抗菌药物使用管理情况分析. 中国药业, 2015, 24(2): 68-69.
11.	王莉, 赵俊英. 重症药疹 45 例临床分析. 中国皮肤性病学杂志, 2012, 26(10): 904-906.
12.	孟慧敏, 李利. 别嘌醇药疹临床特点分析. 华西医学, 2014, 29(1): 96-97.
13.	Karlin E, Phillips E. Genotyping for severe drug hypersensitivity. Curr Allergy Asthma Rep, 2014, 14(3): 418.
14.	Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist. Br J Dermatol, 2007, 158(3): 609-611.
15.	祝伦, 蒋法新, 胡白, 等. 重症药疹 74 例临床分析. 中华临床医师杂志, 2012, 7(6): 4093-4095.
16.	Ardern Jones MR, Friedmann PS. Skin manifestations of drug allergy. Br J Clin Pharmacol, 2011, 71(5): 672-683.
17.	廖理超, 胡白, 赵政龙, 等. 重症药疹 73 例临床分析. 中国麻风皮肤病杂志, 2016, 11(32): 661-662.

1. Li LF, Ma C. Epidemiological study of severe cutaneous adverse drug reactions in a city district of China. Clin Exp Dermatol, 2006, 31(5): 642-647.
2. Lee HY, Chung WH. Toxic epidermal necrolysis: the year in review. Curr Opin Allergy Clin Immunol, 2013, 13(4): 330-336.
3. Kardaun SH, Mockenhaupt M, Roujeau JC. Comments on: DRESS syndrome. J Am Acad Dermatol, 2014, 71(5): 1000-1000. e2.
4. Lissia M, Mulas P, Bulla A, et al. Toxic epidermal necrolysis (Lyell’S disease). Bums, 2010, 36(2): 152-163.
5. 池泽善郎. DIHS及SJS/TEN重症药疹的治疗, 日本医学介绍, 2004, 25(2), 74-75.
6. Kito Y, Ito T, Tokura Y, et al. High-dose intravenous immunoglobulin monotherapy for drug-induced hypersensitivity syndrome. Acta Derm Venereol, 2012, 92(1): 100-101.
7. 钟华, 王欢, 牛军, 等. 547 例皮肤药物不良反应回顾性分析. 中华医学会 2011 年全国变态反应学术会议论文集. 2011, 79(1): 52-56.
8. Riyaz N, Sarita S, Arunkumar G, et al. Drug-induced hypersensitivity syndrome with human herpesvirus-6 reactivation. Indian J Dermatol Venereol Leprol, 2012, 78(2): 175-177.
9. 王国恩, 张晓玲, 刘敏龙, 等. 中毒性表皮松解型药疹 20 例疗效分析. 中国皮肤性病学杂志, 2016, 30(5): 37-39.
10. 焦乾升, 黄忠华, 方卫利, 等. 2013 年第四季度我院抗菌药物使用管理情况分析. 中国药业, 2015, 24(2): 68-69.
11. 王莉, 赵俊英. 重症药疹 45 例临床分析. 中国皮肤性病学杂志, 2012, 26(10): 904-906.
12. 孟慧敏, 李利. 别嘌醇药疹临床特点分析. 华西医学, 2014, 29(1): 96-97.
13. Karlin E, Phillips E. Genotyping for severe drug hypersensitivity. Curr Allergy Asthma Rep, 2014, 14(3): 418.
14. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist. Br J Dermatol, 2007, 158(3): 609-611.
15. 祝伦, 蒋法新, 胡白, 等. 重症药疹 74 例临床分析. 中华临床医师杂志, 2012, 7(6): 4093-4095.
16. Ardern Jones MR, Friedmann PS. Skin manifestations of drug allergy. Br J Clin Pharmacol, 2011, 71(5): 672-683.
17. 廖理超, 胡白, 赵政龙, 等. 重症药疹 73 例临床分析. 中国麻风皮肤病杂志, 2016, 11(32): 661-662.

West China Medical Journal

A clinical analysis of 48 cases of severe drug eruption

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