Clinical patterns of cutaneous adverse drug reactions in tertiary care centre of central India: A cross-sectional study

Abstract

Introduction: Cutaneous adverse drug reactions (CADRs) are the most common adverse reactions attributed to drugs in which any type of skin reaction can be mimicked, induced, or aggravated. Aim and Objectives: To study the morphological patterns of various types of CADRs. Materials and Methods: It was a descriptive cross-sectional study carried out from November 2017 to September 2019, where medical records of diagnosed cases of CADRs were analyzed in a predesigned proforma with respect to demographic data, clinical features, treatment history (topical and oral), offending drug, temporal association with a skin eruption, investigations, and treatment outcome. Statistical analysis was done using mean, median, and proportion. Results: A total of 180 patients with CADRs were enrolled. There was a male preponderance with the mean age being 32.9 ± 2.9 years. The most common CADR reported was fixed drug eruption (n = 77). Steven Johnson syndrome was the most common (n = 7) severe cutaneous adverse reaction. The mean duration of latency was 6.2 (±8.61 days). Antimicrobial drugs accounted for most of the benign as well as severe CADRs (41.4%). Among all cases, 43.9% of patients had mild CADR and 16.7% had severe CADR. Causality assessment using the Naranjo adverse drug reaction probability scale, 70% had a possible association, 18.3% probable and 11.7% had a doubtful association. Conclusion: Early identification of CADR is important to reduce morbidity and mortality. Patient education is required to avoid self-administration of drugs and re-administration of the same offending drugs to prevent further morbidity. Immediate withdrawal of the culprit drug/drugs with adequate management can be lifesaving.

Keywords

• acneiform eruption
• central india
• cutaneous adverse drug reaction
• fixed drug eruption