A Study of Cutaneous Drug Reactions

Objectives: Drug eruption is an age old but fascinating subject. The pattern of adverse drug reactions is changing continuously, as newer drugs are being introduced. This is a modest attempt to study the pattern of adverse drug reactions and their various aspects such as geographic and demographic variations and try to correlate if any among them could have an effect on their causation. Methods: The study included 110 patients admitted for cutaneous ADRs and those who developed reactions when they wereadmitted for other diseases. Patients who were treated on out patient basis were excluded from the study. Adetailed clinical assessment was done in all of them. The attention was paid to the drug history, temporal correlation with drug, duration of the rash, morphology, associated mucdsal or systemic involvement, improvement of lesions on withdrawal of drug and history of recurrence of lesions on rechallenge. Results: The most common cutaneous adverse drug reaction was maculopapular rash (34.54%) followed by Urticaria (23.65%), FDE (13.64%) and SJS-TEN-(10.92%). Most commonly incriminated drugs were antimicrobials (43.63%) followed by NSAlDs (34.55%), antimalarials (9.09%) and anticonvulsants (6.36%). Most cases were seen in the 3rd (34.71%) and 4th (21.89%) decade, with mean age of 34.06 years. Adults aged 20-49 years were at greatest risk of antibiotics-related drug eruptions probably due to increased exposure to antibiotics. Slight male preponderance was observed (M:F=1.29:1). Conclusion: Though the available methods are effective to determine causative agents of drug reactions but not feasible to perform in all cases due to their limitations even in the well equipped tertiary care centres. We observed that sound knowledge of drug reactions and high index of suspicion are the only effective tools to diagnose and report drug reactions.