Pattern of cutaneous adverse drug reactions in an adverse drug monitoring center at a tertiary care hospital in Kerala

Background: Pre-marketing clinical trials can filter only about 50% of the drug reaction. Hence, to prevent the morbidity and mortality due to severe cutaneous reactions early detection, evaluation and monitoring of adverse drug reaction (ADR) especially cutaneous ADR (CADR) are mandatory. Hence, it is imperative that we update our knowledge of the precise nature of ADR which will prevent the reactions as well as to find the offending drug. Aim and Objectives: The aim of the study was to evaluate the pattern of CADR, the suspected drugs and to perform the causality assessment using WHO casualty assessment scale. Materials and Methods: A retrospective descriptive study was done using the data reported to ADR monitoring center in the Department of Pharmacology by the health-care professionals. Suspected CADR was diagnosed by the consultants concerned. The CADRs collected were categorized according to their morphology into maculopapupar rash (MPR), fixed drug eruptions (FDE), urticaria, Stevens-Johnson syndrome, and toxic epidermal necrolysis. The causality assessment was done using WHO Causality assessment scale. Results: The mean age was 47.20 + 22.31. The most common CADR reported was Urticaria 65.5% followed MPR 23%, FDE 8.8%, and Steven Johnsons Syndrome 2.2%. Anti-microbial drugs were the most frequent cause of the adverse reactions with Amoxicillin clavulinic acid combination being the most frequent suspected drug producing CADR (13.3%). The WHO causality assessment for majority of CADR was Possible (73.5%). Conclusion: Clinical Patterns of CADRs in this set up have some minor variations when compared to studies done across India. Amoxicillin clavulinic acid is the most common suspected drug in this study which was not frequently reported in other ADR monitoring centers.

Cutaneous Adverse Effects Associated with Iressa(R)(Gefitinib) Medication / 대한피부과학회지

We report cutaneous adverse effects developed in three patients and are probably related to Iressa(R)(Gefitinib, ZD1839) medication. Iressa(R) is a new anti-cancer agent which acts by inhibiting epidermal growth factor (EGF) receptor signal transduction. The three patients had all taken Iressa(R) for treatment of non-small cell lung cancer and came to our clinic with cutaneous adverse effects. All three patients had acneiform eruptions, and one of the patients also had periungal granulation lesions. Histopathologically, periadnexal inflammatory cellular infiltrations were seen in the acneiform lesions of the three patients and granulation-like tissue proliferations in periungal granulation lesions of the one patient.