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A Nationwide Study of Severe Cutaneous Adverse Reactions Based on the Multicenter Registry in Korea
- Source :
- The Journal of Allergy and Clinical Immunology: In Practice. 9:929-936.e7
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Because severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) rarely occur, clinical data based on large-scale studies are still lacking. Objective To provide information on culprit drugs and clinical characteristics, including morbidity and mortality of SCARs based on a nationwide registry. Methods SCAR cases that occurred from 2010 to 2015 were recruited to the Korean SCAR registry from 34 tertiary referral hospitals. Demographics, causative drugs, causality, and clinical outcomes were collected by reviewing the medical record. Results A total of 745 SCAR cases (384 SJS/TEN cases and 361 DRESS cases) due to 149 drugs were registered. The main causative drugs were allopurinol (14.0%), carbamazepine (9.5%), vancomycin (4.7%), and antituberculous agents (6.3%). A strong preference for SJS/TEN was observed in carbonic anhydrase inhibitors (100%), nonsteroidal anti-inflammatory drugs (84%), and acetaminophen (83%), whereas dapsone (100%), antituberculous agents (81%), and glycopeptide antibacterials (78%) were more likely to cause DRESS. The mortality rate was 6.6% (SJS/TEN 8.9% and DRESS 4.2%). The median time to death was 19 days and 29 days in SJS/TEN and DRESS respectively, and 89.8% of deaths occurred within 60 days after the onset of the skin symptoms. Conclusion Allopurinol, carbamazepine, vancomycin, and antituberculous agents were the leading causes of SCARs in Korea. Some drugs preferentially caused a specific phenotype. The mortality rate of SCARs was 6.6%, and most of the deaths occurred within 2 months.
- Subjects :
- medicine.medical_specialty
Allopurinol
Scars
Dapsone
law.invention
03 medical and health sciences
0302 clinical medicine
law
Republic of Korea
medicine
Humans
Immunology and Allergy
Registries
030212 general & internal medicine
business.industry
Medical record
Mortality rate
Carbamazepine
medicine.disease
Intensive care unit
Dermatology
Toxic epidermal necrolysis
030228 respiratory system
Stevens-Johnson Syndrome
Vancomycin
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 22132198
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- The Journal of Allergy and Clinical Immunology: In Practice
- Accession number :
- edsair.doi.dedup.....7d9bf0802d8816847856d1f74da8cb96
- Full Text :
- https://doi.org/10.1016/j.jaip.2020.09.011