Severe Cutaneous Adverse Reactions: A Single-Center Retrospective Study of 173 Patients in China
Annals of Dermatology
;
: 545-554, 2019.
Article
Dans Anglais
| WPRIM
| ID: wpr-762374
ABSTRACT
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.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Pronostic
/
Peau
/
Soins de santé tertiaires
/
Carbamazépine
/
Chine
/
Allopurinol
/
Santé publique
/
Études rétrospectives
/
Mortalité
/
Cicatrice
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
Pays comme sujet:
Asie
langue:
Anglais
Texte intégral:
Annals of Dermatology
Année:
2019
Type:
Article
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