scholarly journals Paracetamol induced bullous fixed drug eruptions

2019 ◽  
Vol 7 (12) ◽  
pp. 4800
Author(s):  
Kalyani Pai Kakode ◽  
Varun Pai Kakode
Keyword(s):  
Reaction Monitoring ◽  
Drug Reactions ◽  
Over The Counter ◽  
Adverse Drug Reaction Monitoring ◽  
Delay In Diagnosis ◽  
Prompt Treatment ◽  
Good Safety Profile ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Inflammatory Action

Paracetamol is a commonly used antipyretic and analgesic with a weak anti-inflammatory action with a good safety profile in children and adults. This has resulted in its over prescription and large over the counter sale. Thus, adverse drug reactions due to paracetamol may be easily overlooked resulting in delay in diagnosis. Author present a case report of a 12 year old boy with bullous fixed drug eruptions due to paracetamol while he tolerated NSAIDS well. This highlights the need of adverse drug reaction monitoring and reporting, for early detection and prompt treatment of drug related morbidity and the cautious use of even the most commonly used drugs.

scholarly journals A Review of Adverse Cutaneous Drug Reactions Resulting from the Use of Interferon and Ribavirin

2009 ◽  
Vol 23 (10) ◽  
pp. 677-683 ◽  
Author(s):  
Nisha Mistry ◽  
Jonathan Shapero ◽  
Richard I Crawford
Keyword(s):  
Side Effects ◽  
Drug Reactions ◽  
Drug Induced ◽  
Common Cause ◽  
Injection Site Reactions ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Life Threatening ◽  
Cutaneous Drug Reactions ◽  
Systemic Drug

Drug-induced cutaneous eruptions are named among the most common side effects of many medications. Thus, cutaneous drug eruptions are a common cause of morbidity and mortality, especially in hospital settings. The present article reviews different presentations of drug-induced cutaneous eruptions, with a focus on eruptions reported secondary to the use of interferon and ribavirin. Presentations include injection site reactions, psoriasis, eczematous drug reactions, alopecia, sarcoidosis, lupus, fixed drug eruptions, pigmentary changes and lichenoid eruptions. Also reviewed are findings regarding life-threatening systemic drug reactions.

scholarly journals A clinicoepidemiological study of fixed drug eruptions at a tertiary centre of North India

2018 ◽  
Vol 7 (1) ◽  
pp. 151
Author(s):  
Rohini Sharma ◽  
Sameer Abrol
Keyword(s):  
Research Work ◽  
Developed Countries ◽  
Skin Lesions ◽  
North India ◽  
Drug Reactions ◽  
Tertiary Centre ◽  
Drug Eruptions ◽  
Culprit Drug ◽  
Mucosal Involvement ◽  
Fixed Drug

Background: Various studies have found the overall incidence of cutaneous adverse drug reactions (CADR’s) in developed countries as 1-3%, while the incidence in developing countries is thought to be higher between 2 and 5%. FDEs’ share is seen to be about 15 -30% of all CADR’s as reported in various studies. Aim of the research work was to study the clinical and epidemiological features of fixed drug eruptions and to identify probable culprit drug or drugs using Naranjo ADR probability scale and to provide information to the patient regarding the drug responsible for his/her drug rash.Methods: A total of 180 patients of fixed drug eruptions were taken up for study who presented to skin OPD at a tertiary centre of North India. Diagnosis was made on the basis of history of drug intake prior to drug eruption, repetition of similar lesions on same as well as new sites on intake of same drug with improvement of skin lesions on discontinuation of the causative drug. Further on examination, skin lesions with typical morphology compatible with FDE were seen. Causality of the FDE was assessed according to the NARANJO ADR probability scale.Results: A total of 180 patients of FDE were studied. Males outnumbered the females. The most common class of drug implicated was antimicrobials seen in 115 patients followed by NSAIDS 65 patients. Regarding the clinical presentation both skin and mucosal involvement was seen. The most common skin lesions were erythematous to hyperpigmented and violaceous macules followed by bullous FDE.Conclusions: In summary, early recognition of FDE is important not only for the dermatologists but also for the clinicians of other specialties, so that the culprit drug is recognized and stopped immediately. Drug reactions are a common reason for litigation and has medicolegal pitfalls.

Cutaneous reactions to drugs

2020 ◽  
pp. 5752-5760
Author(s):  
Sarah Walsh ◽  
Daniel Creamer ◽  
Haur Yueh Lee
Keyword(s):  
Adverse Drug Reactions ◽  
Adverse Reactions ◽  
Normal Function ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Drug Induced ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Iatrogenic Illness ◽  
Systemic Symptoms

Adverse reactions to medications are common and important cause of iatrogenic illness. Severe cutaneous adverse drug reactions include toxic epidermal necrolysis, Stevens–Johnson syndrome, drug reaction with eosinophilia and systemic symptoms, and acute generalized exanthematous pustulosis, which together constitute 2% of all adverse drug reactions and may be life-threatening. Less severe drug-induced skin reactions such as exanthems, urticaria, lichenoid drug rashes, and fixed drug eruptions are more common, sometimes termed benign cutaneous adverse reactions, and generally resolve without sequelae. Drugs may also cause adverse events due to alteration of the normal function of the skin or its appendages. This may take the form of photosensitivity, abnormal pigmentation, or disrupted growth of hair or nails.

scholarly journals Drug allergy in children: what should you know?

2021 ◽  
Vol 16 (1) ◽  
pp. 52-59
Author(s):  
S.L. Nyankovskyy ◽  
О.S. Nyankovska ◽  
M.S. Yatsula ◽  
M.I. Horodylovska
Keyword(s):  
Drug Allergy ◽  
Hospital Admissions ◽  
Medical Problem ◽  
Cross Reactivity ◽  
Allergic Reactions ◽  
Age Group ◽  
Drug Reactions ◽  
Over The Counter ◽  
Drug Eruptions ◽  
Over The Counter Medicines

Drug reactions cause 6.5 % of all hospital admissions. They develop with a rate of 15 % in patients who are trea­ted in hospitals. The risk of drug reactions should be considered in the differential diagnosis when any medical problem occurs in a person who uses medication. In children, the major difficulty in the diagnosis of drug allergy is differentiation of maculopapular drug eruptions from viral exanthem which is observed very commonly in this age group. In treatment of allergic reactions, the first step is to immediately discontinue the drug. Avoidance of using over-the-counter medicines and using drugs orally if possible are important in terms of prevention of drug allergies. Cross-reactivity between drugs with similar structure should be considered when choosing an alternative medication. Antihistamines, in particular dimetindene maleate — Edermik, can be used for the prevention and treatment of drug reactions at the outpatient stage.

scholarly journals Adverse cutaneous drug reactions reporting in a tertiary care teaching hospital in Eastern India: a retrospective study

2020 ◽  
Vol 9 (9) ◽  
pp. 1381
Author(s):  
Manika Bose ◽  
Debasish Misra ◽  
Sansita Parida ◽  
Smita Das ◽  
Swati Mishra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Drug Reactions ◽  
Morphological Pattern ◽  
Common Drug ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Cutaneous Reactions ◽  
Cutaneous Drug Reactions ◽  
Major Drug ◽  
Cutaneous Drug Reaction

Background: Any unwanted changes to mucous membrane, skin, its appendages and drug eruptions related adverse events are known as adverse cutaneous drug reaction (ACDR). It has 2-5% incidence in developing countries. The current study was undertaken to analyse adverse cutaneous drug reactions spectrum clinically, drugs responsible, assessment of causality, severity, and preventability in our setup.Methods: Current study was an observational, retrospective, non-interventional analysis of voluntarily reported ADRs forms, between April 2018 and January 2020.  All cutaneous ADRs reported within this period were identified. Data obtained were expressed in numbers, percentages.Results: 130 cutaneous ADRs was reported during the period of study. Fixed drug eruptions (30%) was the most common cutaneous reaction. The most common causal drug groups were antimicrobials (58.5%). Amongst antimicrobials, ornidazole (8.5%) was the most common drug. The most common drug in NSAID group was paracetamol (14.6%). The major drug causing ACDRs in our study was Paracetamol (14.6%). Assessment of causality revealed 37.7% were probable and 62.3% were possible reactions. Assessment of severity showed 78.5% as mild and 21.5% as moderate. Assessment of preventability showed that 6.1% probably preventable and 93.9% not preventable.Conclusions: Knowledge of the pattern of cutaneous reactions and the causative drugs guides us in early diagnosis of the condition, better management and associated decrease in morbidity, mortality. In the current study, the most common causal drug group were antimicrobials. The most common morphological pattern and drug causing ACDRs were fixed drug eruptions and paracetamol, respectively.

scholarly journals Cutaneous adverse drug reactions in a tertiary care hospital: An observational study

2020 ◽  
Vol 1 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Baijayanti Rath ◽  
Manas Ranjan Naik ◽  
Bhabagrahi Rath ◽  
Renuka Bhoi ◽  
Jai Prakash
Keyword(s):  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Severity Assessment ◽  
Drug Reactions ◽  
Fixed Drug Eruption ◽  
Antitubercular Drugs ◽  
Drug Eruptions ◽  
Fixed Drug

Introduction: Cutaneous adverse drug reactions (CADRs) are one of the most common ADRs caused by drugs causing a lot of morbidity and mortality. The overall incidence of CADRs in developed countries is 1-3 %, while that in the developing countries is reported to be higher between 2 % and 5 %. Changes in drug metabolism drug interactions, oxidative stress, and various cytokines are the various factors that cause cutaneous adverse drug reactions. Aim and objective: This study aims to evaluate the patterns of CADRs, the causative drugs along with causality and severity assessment. Methods: A total of 50 Patients with cutaneous adverse drug reactions who were included in our last study attended skin OPD, VIMSAR Burla, from June 2018 to September 2018 and were analyzed for causality assessment using the WHO-UMC scale and severity assessment using  Hartwig and Siegel's scale. Results: Out of 50 patients, 48 % belong to the age group 21-40 years. Around 44 % of CADRs were fixed drug eruptions. NSAID was found to be the most offending drug and it contributed to a maximum of 32 % of ADRs. 16 % of ADRs were found to be caused by antitubercular drugs. Paracetamol was the key NSAID, contributing 87.5 % of ADRs. Causality was certain, probable, and possible for 8 %, 24 %, and 60 % of ADRs respectively. Severity was mild for 64 % and moderate for 34 % of ADRs. Conclusions: NSAID and antitubercular drugs are the commonest drugs causing CADRs. Fixed drug eruption is the most common CADRs and the commonest drug was paracetamol. Causality grade was possible and the severity grade was mild.

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