Severe Cutaneous Adverse Drug Reactions in Children: Epidemiological, Clinical and Etiological Aspects in Dermatology-Venereology Unit at National and Teaching Hospital of Cotonou.

BACKGROUND: The aim of this study was to describe the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children in dermatologyvenereology unit at National and Teaching Hospital of Cotonou. METHODS: A retrospective and descriptive study was carried out for 10 years in dermatology-venereology unit at the National and Teaching Hospital of Cotonou to document the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children. It included all children aged from 0 to 18 years with clinical diagnosis of severe cutaneous adverse drug reactions. Drug imputability was based on the criteria of the French pharmacovigilance group. RESULTS: Severe cutaneous adverse drug reactions accounted for 47.3% of paediatric cases (35/74 cases). The mean age was 9.3 years ± 5.2. The sex-ratio was 1.1. Self-medication was noted in 76.5% of children, on the initiative of parents in 66.7% of cases. There were 51.4% cases of Steven Johnson syndrome, 22.8% cases of Lyell syndrome, 8.5% cases of generalized and bullous fixed drug eruption, 2.9% cases of acute generalized exanthematous pustulosis and erythrodermic maculo-papular rash. Drug combinations was noted in 20% of cases. Penicillins (26.5%), paracetamol and sulfonamides (16.3%) were the drugs frequently incriminated. CONCLUSION: Steven Johnson syndrome and Lyell syndrome were the main severe cutaneous adverse drug reactions in children, mostly of school age. Penicillins, paracetamol and sulfonamides were the drugs frequently used and administered most often on self-medication.

INTRODUCTION: L'objectif de cette étude était de décrire les aspects épidémiologiques, cliniques et étiologiques des toxidermies graves chez les enfants en dermatologie à Cotonou. METHODES: Une étude rétrospective et descriptive a été réalisée sur 10 ans dans le service de dermatologie du Centre National Hospitalier et Universitaire de Cotonou pour documenter les aspects épidémiologiques, cliniques et étiologiques des toxidermies graves chez les enfants. Étaient inclus tous les enfants âgés de 0-18 ans chez qui le diagnostic clinique de toxidermie grave a été retenu. L'imputabilité médicamenteuse était basée sur les critères du groupe français de pharmacovigilance. RESULTATS: Les toxidermies graves représentaient 47,3% des cas pédiatriques (35/74 cas). L'âge moyen était de 9,3 ans ± 5,2. La sex-ratio H/F était de 1,1. Une automédication a été notée chez 76,5% des enfants, sur l'initiative des parents dans 66,7% des cas. Il y avait 51,4% de cas de syndrome de Steven Johnson, 22,8% de cas de syndrome de Lyell, 8,5% de cas d'érythème pigmenté fixe bulleux étendu, 2,9% de pustulose exanthématique aigüe généralisée et d'exanthème maculo-papuleux eìrythrodermique. Une polymédication a été notée dans 20% des cas. Les pénicillines (26,5%), le paracétamol et les sulfamides (16,3%) étaient les médicaments fréquemment incriminés. CONCLUSION: Le syndrome de Steven Johnson et le syndrome de Lyell étaient les principales toxidermies graves chez les enfants, majoritairement en âge scolaire. Les pénicillines, le paracétamol et les sulfamides étaient les médicaments fréquemment incriminés et administrés le plus souvent en automédication. Mots clés: Toxidermies graves, syndrome de Steven Johnson, syndrome de Lyell, automédication, sulfamides, enfants, Benin.

A new mammography dosimetric phantom.

Breast phantoms produced with tissue-equivalent materials are used in an attempt to simulate glandular and adipose tissues, in terms of X-ray attenuation and density. In this work, a set of breast tissue-equivalent phantoms (BTE phantoms) with semicircular shapes of different thicknesses and compositions were produced. Such phantoms may be used in the measurement of the incident air kerma (K(i)) and the mean glandular dose (D(G)) delivered to patients undergoing mammography. To characterise the materials used to produce the phantoms, a series of 17-keV X-ray attenuation coefficient measurements were performed. The carbon-nitrogen-hydrogen elemental composition and the densities of the tissue-equivalent materials were also determined and compared with values available in the literature. Linear attenuation coefficients of 0.724 and 0.923 cm(-1) were determined, respectively, for adipose and glandular tissues. Such values agree with data available in the literature. On the basis of the results obtained in this work, it is suggested that BTE phantoms are used instead of polymethyl methacrylate phantoms to select exposure parameters (kV, mAs and target/filter combination) specific for breast glandularities from 0 to 50 % in the optimisation of doses in mammography.