Severe idiosyncratic drug reactions with epidermal necrolysis: A 5-year study

被引:4
作者
Fadeyibi, I. O. [1 ]
Ademiluyi, S. A. [2 ]
Ajose, F. O. [3 ]
Jewo, R. I. [4 ]
Akinola, O. I. [1 ]
机构
[1] Lagos State Univ, Teaching Hosp, Coll Med, Dept Surg,Burns & Plast Surg Unit, Oba Akinjobi St, Lagos, Nigeria
[2] Lagos State Univ, Teaching Hosp, Coll Med, Dept Med,Burns & Plast Surg Unit, Lagos, Nigeria
[3] Lagos State Univ, Teaching Hosp, Coll Med, Dept Anat,Burns & Plast Surg Unit, Lagos, Nigeria
[4] Lagos State Univ, Teaching Hosp, Coll Med, Dept Obstetr & Gynecol,Burns & Plast Surg Unit, Lagos, Nigeria
关键词
Idiosyncratic drug reactions; Stevens Johnson Syndrome; Toxic Epidermal Necrolysis; toxic epidermal necrolysis;
D O I
10.4103/0970-0358.90824
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Idiosyncratic drug reactions (IDRs) are unexpected responses to a drug. The spectrums of severe cutaneous reactions include Stevens-Johnson Syndrome (SJS), SJS/Lyell Syndrome and Toxic Epidermal Necrolysis (TEN). The conditions are associated with high mortality. This study was designed to determine the causal agents, patterns of presentations, review the management and make recommendations to reduce the incidence and mortality of this class of drug reactions. Materials and Methods: A retrospective study was made of patients seen with IDR in the Lagos State University Teaching Hospital, LASUTH, between January, 2004 and December, 2008. They were cases admitted with bullous skin eruptions with associated systemic symptoms. Results: Sixty-seven patients were seen, with 45 (67.2%) satisfying the inclusion criteria. Fifteen males and 30 females were involved, giving a male to female (M:F) ratio of 1:2. Their ages ranged from 7 to 79 years (mean, 40.02 +/- 17.89 years). Peak incidences occurred among the 20-24 and 30-34 year age groups. The causal agents were antibiotics (48.89%), sulphonamides (24.44%), herbal preparations (17.78%) and artemisinin drugs (8.89%). Conclusions: The age groups with the peak incidence are the most likely to indulge more in drug abuse in environments with poor drug control. Diagnosis of SJS, SJSITEN and TEN were missed in many patients at first contact due to the progressive nature of the conditions. Patients needed reviews at regular intervals when IDR was suspected. Health education to prevent drug abuse is important and herbal preparations should be scientifically studied to determine the efficacy and side-effects.
引用
收藏
页码:467 / 473
页数:7
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