Severe Cutaneous Adverse Reactions: A Single-Center Retrospective Study of 173 Patients in China

BACKGROUND: Severe cutaneous adverse reactions (SCAR) to drugs are a crucial public health issue and the use of systemic corticosteroids in SCAR has been controversial. OBJECTIVE: To analyze clinical features, causative drugs, treatment, outcomes, and prognostic factors of SCAR in the case-series of 173 patients, and add more information to the debate of using systemic corticosteroids in SCAR management. METHODS: A retrospective study of 173 SCAR patients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) or acute generalized exanthematous pustulosis (AGEP) at a tertiary care institution in China between January 2014 and December 2017 was conducted. RESULTS: Of 173 patients, allopurinol, carbamazepine, and antibiotics are the most frequently implicated drugs for DRESS (40.4%), SJS/TEN (26.0%), and AGEP (40.0%) respectively. Moreover, there is a strongly negative correlation between early corticosteroids use and the progression (p=0.000) and severity (p=0.01) of skin lesions. However, there is no association between early corticosteroids use and the mortality of SCAR (odds ratio: 1.01, 95% confidence interval: 0.95~1.08). In addition, lymphadenopathy, eosinophilia, and interval from onset to corticosteroids treatment were correlated with SCAR prognosis. CONCLUSION: Prompt short-course systemic corticosteroids use is associated with early-stage skin lesions remission without influencing the disease mortality. Lymphadenopathy and eosinophilia were the independent poor prognostic factors of SCAR.

Xiaozhi Jiangmei Decoction Treat Fat Liver together with Abnormal Liver Function / 浙江中医药大学学报

Objective To evaluate the curative effect of Xiaozhi Jiangmei Decoction in treating fat liver with abnormal liver function. Method 60 patients of fat liver with abnormal liver function take themselves as control, all taking Xiaozhi Jiangmei Decoction; observe for 3 months in succession. Result After 3 months, the serum glutamic pyruvic transaminase(GPT) increased to 39.21?3.42 from 67.31?2.52, the glutamic oxaloacetic transminase(GOT) decreased to 41.12?2.82 from 68.52?3.12. Meanwhile, the liver B ultrasound exam showed much relieved fat liver, even disappeared. Conclusion Xiaozhi Jiangmei Decoction has reliable therapeutic effect in removing symptoms of fat liver and protecting liver function, without any side effects.