Toxic epidermal necrolysis due to Dapsone treatment in a patient with Hansen's disease: a case report

Dapsone is a sulfone antimicrobial and is used widely as an antileprotic medication. The commonly encountered cutaneous adverse drug reactions [ADR] due to dapsone are exfoliative dermatitis, toxic 'erythema, erythema multiforme, morbilliform and scarlatiniform eruptions, urticaria, erythema nodusum and toxic epidermal necrolysis [TEN]. We hereby report a case of toxic epidermal necrolysis caused due to dapsone. The causality, severity and preventability assessments were carried out. The patient was treated with systemic hydrocortisone, antibiotics and other symptomatic drugs. The reaction was severe and the patient expired on the second day of hospital admission in spite of the treatment. Since TEN is a life threatening cutaneous ADR and dapsone is a commonly used drug, this reaction needs monitoring

Morbilliform rashes due to erythromycin in a patient with herpes zoster infection

Erythromycin is a macrolide antibiotic active against many gram-positive infections and few gram-negative bacteria, as well as mycoplasmas, spirochetes, chlamydiae and rickettsiae. Dermatological reactions appear to be rare with erythromycin and mainly include maculopapular rashes, pruritus, urticaria, and angioedema, Reports of morbiliform rashes due to erythromycin are rare. We report a case of morbiliform reaction due to erythromycin in a patient suffering from herpes zoster with established causality, severity and preventability assessments. Upon development of the adverse drug reaction, we stopped the drug and managed the patient with systemic corticosteroids

Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital in Nepal

Use of cancer chemotherapeutic drugs is associated with several adverse drug reactions [ADRs] ranging from mild nausea to fetal myelosuppression. Data regarding safety profile of cancer chemotherapy is lacking in Nepal. To study the pattern of ADRs caused by cancer chemotherapeutic drugs in Manipal Teaching Hospital [MTH], pokhara, Nepal. Hospitalized patients treated with cancer chemotherapy drugs from 1st January to 30th June 2006, was studied retrospectively. Necessary information was collected from the patients' hospital records. Total 60 patients underwent chemotherapy among which 25 [41.67%] developed ADRs. More than half [60%] were male and 40% were of age group 6170 years. The mean +/- SD age was 57.8 +/- 11.54 years. More than half of the patients [50%] who developed ADRs were on adjuvant chemotherapy. Alkylating agents were responsible for the ADRs in nearly half of the patients [52%] followed by antimetabolites [20%]. Cisplatin was the individual drug responsible for 44% of the ADRs. The onset of the ADR was within aday in 44% of the patients. Thirty six percent of patients developing ADRs stayed in the hospital for 14 days. Hematological system was affected primarily [40.47% of the patients], followed by the gastrointestinal tract [33.33%]. Grade I neutropenia was the most common ADR affecting 28.6% of the patients, followed by emesis [21.4%]. Increased dose of antiemetics was needed in 38.5% of the patients to manage the ADRs. Levamisole was the drug used primarily [30.43%] for managing ADRs. Male patients and age 61-70 years were highly predisposed to ADRs. Cisplatin was the common drug responsible for ADRs. Levamisole was commonly used in managing the ADRs. Similar studies covering more patients from different regions are needed to validate our findings