ABSTRACT
To study the various clinical patterns of cutaneous adverse drug reactions [ADRs] and to identify the causative drugs. A cross-sectional hospital based study was carried out with patients reporting with cutaneous ADRs to the Department of Dermatology at GMC Hospital, Ajman, U. A. E., between 2010 and 2012. Medical records of the patients were used to obtain demographic, diagnostic and ADR-related information. The data were subjected to detailed statistical analysis using SPSS. 19 software. A total of 43 patients were included [46.5% males and 53.5%females] in the study. The mean age of the patients was 30.07+.-13.63 years. The majority of the patients were from the Middle East, followed by Asian countries. The commonest cutaneous ADRs seen were maculo-papular rash [48.8%], Erythroderma [18.6%], urticaria [11.7%] and Fixed drug eruption [11.7%]. The drugs most responsible for the various cutaneous ADR were antimicrobials in 11[48.8%] and NSAIDs in 14 [32.5%] cases. Carbamazepine and Ciprofloxacin were responsible for two cases [6%] of life-threatening Stevens Johnson syndrome. Mean reaction timewas 5.63 +/- 0.5 days. Reactions were mild [46.7%], moderate [40%] and severe [13.3%]. Based on the WHO Causality assessment of ADRs, 34 [80%] cases were probable in nature; 8 [27%] possible and 1 [3%] case uncertain. A total of 5 [11.6%] cases had past history of ADRs. Three patients [9%] had secondary bacterial infection over ADR lesions and required antimicrobial treatment. The clinical pattern of ADRs and the drugs causing cutaneous ADRs was largely similar to that observed in other countries
Subject(s)
Humans , Male , Female , Drug-Related Side Effects and Adverse Reactions , Dermatitis, Exfoliative/chemically induced , Surveys and Questionnaires , Emergency Medicine , Cross-Sectional Studies , Hospitals/statistics & numerical data , Tertiary Care CentersABSTRACT
Acute intoxication with methotrexate, used as an abortive, has not been described in Chile. We report two female patients, aged 15 and 24 years old, who presented with mucositis, erythrodermia, pancytopenia, and elevation of hepatic enzymes. Plasma methotrexate levels confirmed the clinical diagnosis and both patients were treated with high leucovorin doses and management of associated complications. In one patient, pregnancy continued, giving birth to a newborn with cranial, face and limb malformations. The second patient had a late rescue with leucovorin and was discharged with a persistent sensory motor neuropathy. Considering the severity of complications and that patients may deny its use, when there is reasonable clinical suspicion of methotrexate intoxication, leucovorin treatment should be started