Cutaneous Adverse Drug Reactions

2018 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Cutaneous Adverse Drug Reactions

2012 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Cutaneous Adverse Drug Reactions

2012 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Ciprofloxacin-Induced Bullae of the Lower Extremity: A Case of a Fixed Drug Reaction

2019 ◽  
Vol 109 (2) ◽  
pp. 155-158 ◽  
Author(s):  
Anthony J. Mollica ◽  
Albert J. Mollica ◽  
Elaine Grant ◽  
Ali Malik ◽  
Marc Claydon
Keyword(s):  
Drug Reaction ◽  
Adverse Drug Reactions ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Adverse Side Effect ◽  
Drug Reactions ◽  
Johnson Syndrome ◽  
Fixed Drug ◽  
Cutaneous Drug Reactions ◽  
Exanthematous Pustulosis

Cutaneous adverse drug reactions make up 1% to 2% of all adverse drug reactions. From these adverse cutaneous drug reactions, 16% to 21% can be categorized as fixed drug reactions (FDR). Fixed drug reactions may show diverse morphology including but not limited to the following: dermatitis, Stevens-Johnson syndrome, urticaria, morbilliform exanthema, hypersensitivity syndrome, pigmentary changes, acute generalized exanthematous pustulosis, photosensitivity, and vasculitis. An FDR will occur at the same site because of repeated exposure to the offending agent, causing a corresponding immune reaction. There are many drugs that can cause an FDR, such as analgesics, antibiotics, muscle relaxants, and anticonvulsants. The antibiotic ciprofloxacin has been shown to be a cause of cutaneous adverse drug reactions; however, the fixed drug reaction bullous variant is rare. This case study was published to demonstrate a rare adverse side effect to a commonly used antibiotic in podiatric medicine.

scholarly journals A clinical study of morphological patterns of cutaneous adverse drug reaction and its causality assessment in tertiary care hospital of central India

2020 ◽  
Vol 9 (10) ◽  
pp. 1528
Author(s):  
Tanaji R. Shende ◽  
Riyaz A. Siddiqui
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Adverse Drug Reactions ◽  
Drug Eruption ◽  
Causality Assessment ◽  
Age Group ◽  
Drug Reactions ◽  
Fixed Drug Eruption ◽  
Fixed Drug ◽  
Cutaneous Adverse Drug Reaction

Background: Adverse reactions to drugs are as old as drug. Cutaneous adverse drug reactions are the most common type of drug reaction. Most cutaneous adverse drug reactions are important as they are frequently the reason for discontinuation of drug therapy. Looking to this matter the study was undertaken.Method: It was an observational study conducted at NKP Salve Institute of Medical Science & Research Centre, Nagpur Maharashtra. A total number of 80 patients having cutaneous adverse drug reaction were evaluated. All the patients were assessed for cutaneous adverse drug reaction during the study period and the information was carefully recorded in standard Adverse drug reaction (ADR) form and Naranjo’s algorithm was used for causality assessment of adverse drug reaction.Result: The maximum study subjects were in the age group of 41-50 years (32-50%) followed by the age group of 31-40 years (25%) followed by other age groups. In study group male to female ratio was 11.5:8.5. Majority of cutaneous adverse drug reactions comprise of fixed drug eruption which is 45%. Most of the cutaneous ADR’s were caused by antibiotics (42.5%) followed by Non-steroidal anti-inflammatory drugs (NSAIDS) (20%). The study subjects were in probable causality assessment of Naranjo’s scale i.e. 82.5% followed by definite in (12.5%) and possible (5%).Conclusion: The fixed drug eruption was the most common cutaneous adverse drug reaction and most of these drugs eruptions were caused by antimicrobial agents. The study provided the base line information about the prevalence of cutaneous adverse drug reaction and their morphological distribution amongst different age group, gender and the causative drug.

scholarly journals Comparison of Clinico-Epidemiological Features of Cutaneous Adverse Drug Reactions

2020 ◽  
Vol 7 (44) ◽  
pp. 2550-2556
Author(s):  
Munnaluri Mohan Rao ◽  
Kotha Raghupathi Reddy ◽  
Chittla Sravan
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Common Cause ◽  
Epidemiological Features ◽  
Drug Eruptions ◽  
Adults And Children ◽  
Cutaneous Adverse Drug Reaction

BACKGROUND Cutaneous adverse drug reactions are an important group of disorders which pose considerable amount of diagnostic and therapeutic challenges. The incidence of CADRs is estimated to be 1 - 2 % in the general population. We wanted to compare the clinico-epidemiological features of cutaneous adverse drug reactions in children and adults. METHODS The study sample comprised of two hundred and twenty patients of CADRs over a period of one and a half years. Patients were assessed using the WHO based algorithm of causality assessment of adverse drug reactions. RESULTS 222 rashes were seen in 220 patients and 315 drugs were implicated. The incidence of CADRs among dermatology patients was 10.18 per thousand patients. The incidence of CADRs among adults and children was 10.15 and 10.34 per thousand patients respectively. Out of the two hundred and twenty cases, thirty five (15.9 %) were in the paediatric age group (< 18 years of age). The most common cutaneous adverse drug reaction seen in our patients was maculopapular rash which was seen in 22 % patients. Antimicrobials were found to be the most common cause of CADRs in both adults and children, while drugs acting on the central nervous system were a close second. When rashes were taken individually, antimicrobials were the most common cause of maculopapular reactions, urticaria and toxic epidermal necrolysis in both children and adults. Acneiform eruptions were caused by steroids in 82 % of cases. Although fixed drug eruptions were most commonly caused by antimicrobials in adults (especially quinolones and nitroimidazoles), NSAIDs particularly nimesulide was also implicated in a substantial number of cases. CONCLUSIONS Newer antibiotics like cephalosporins are being used more often and thus a higher number of adverse drug reactions are seen with them. Therefore it would be useful for every individual institution to maintain a drug reaction registry. KEYWORDS Cutaneous Adverse Drug Reaction, Maculopapular Reactions, Urticaria, Toxic Epidermal Necrolysis

scholarly journals The class imbalance problem detecting adverse drug reactions in electronic health records

2018 ◽  
Vol 25 (4) ◽  
pp. 1768-1778 ◽  
Author(s):  
Sara Santiso ◽  
Arantza Casillas ◽  
Alicia Pérez
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Electronic Health Records ◽  
Adverse Drug Reactions ◽  
Class Imbalance ◽  
Drug Reactions ◽  
Class Imbalance Problem ◽  
Health Records ◽  
Imbalance Problem ◽  
Electronic Health

This work focuses on adverse drug reaction extraction tackling the class imbalance problem. Adverse drug reactions are infrequent events in electronic health records, nevertheless, it is compulsory to get them documented. Text mining techniques can help to retrieve this kind of valuable information from text. The class imbalance was tackled using different sampling methods, cost-sensitive learning, ensemble learning and one-class classification and the Random Forest classifier was used. The adverse drug reaction extraction model was inferred from a dataset that comprises real electronic health records with an imbalance ratio of 1:222, this means that for each drug–disease pair that is an adverse drug reaction, there are approximately 222 that are not adverse drug reactions. The application of a sampling technique before using cost-sensitive learning offered the best result. On the test set, the f-measure was 0.121 for the minority class and 0.996 for the majority class.

scholarly journals Promoting adverse drug reaction reporting: comparison of different approaches

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Inês Ribeiro-Vaz ◽  
Cristina Costa Santos ◽  
Ricardo Cruz-Correia
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Cost Effectiveness ◽  
Adverse Drug Reactions ◽  
Health Care Professionals ◽  
Adverse Drug Reaction Reporting ◽  
Pharmacovigilance Centre ◽  
Drug Reactions ◽  
Educational Approach ◽  
Reaction Reporting

ABSTRACT OBJECTIVE To describe different approaches to promote adverse drug reaction reporting among health care professionals, determining their cost-effectiveness. METHODS We analyzed and compared several approaches taken by the Northern Pharmacovigilance Centre (Portugal) to promote adverse drug reaction reporting. Approaches were compared regarding the number and relevance of adverse drug reaction reports obtained and costs involved. Costs by report were estimated by adding the initial costs and the running costs of each intervention. These costs were divided by the number of reports obtained with each intervention, to assess its cost-effectiveness. RESULTS All the approaches seem to have increased the number of adverse drug reaction reports. We noted the biggest increase with protocols (321 reports, costing 1.96 € each), followed by first educational approach (265 reports, 20.31 €/report) and by the hyperlink approach (136 reports, 15.59 €/report). Regarding the severity of adverse drug reactions, protocols were the most efficient approach, costing 2.29 €/report, followed by hyperlinks (30.28 €/report, having no running costs). Concerning unexpected adverse drug reactions, the best result was obtained with protocols (5.12 €/report), followed by first educational approach (38.79 €/report). CONCLUSIONS We recommend implementing protocols in other pharmacovigilance centers. They seem to be the most efficient intervention, allowing receiving adverse drug reactions reports at lower costs. The increase applied not only to the total number of reports, but also to the severity, unexpectedness and high degree of causality attributed to the adverse drug reactions. Still, hyperlinks have the advantage of not involving running costs, showing the second best performance in cost per adverse drug reactions report.

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