Clinical pattern of cutaneous drug eruption among children and adolescents in north India.
Various types of cutaneous drug eruptions and the incriminating drugs were analyzed in 50 children and adolescents up to 18 years of age (34 or 65% boys, 16 or 32% girls). Thirteen (26%) patients had a maculopapular rash, 11 (22%) a fixed drug eruption (FDE), 10 erythema multiforme (EM), 6 (12%) toxic epidermal necrolysis (TEN), 5 (10%) Stevens-Johnson syndrome (SJS), 3 (6%) urticaria, and 2 (4%) erythroderma. The incubation period for maculopapular rashes, SJS and TEN due to commonly used antibiotics and sulfonamides was short, a few hours to two to three days, reflecting reexposure, and for drugs used sparingly such as antiepileptics and antituberculosis agents, was approximately one week or more, suggesting a first exposure. Antibiotics were responsible for cutaneous eruptions in 27 patients, followed by antiepileptics in 17, analgin in 4, and metronidazole and albendazole in 1 each. Cotrimoxazole, a combination of sulfamethoxazole and trimethoprim, was the most common antibacterial responsible for eruptions (11 patients), followed by penicillin and its semisynthetic derivatives (8 patients), sulfonamide alone (3 patients), and other antibiotics (4 patients). Antiepileptics were the most frequently incriminated drugs in EM, TEN, and SJS. The role of systemic corticosteroids in the management of SJS and TEN is controversial. We administered prednisolone or an equivalent corticosteroid 2 mg/kg/day for 7 to 14 days.(ABSTRACT TRUNCATED AT 250 WORDS)
Sharma
V K
VK
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Dhar
S
S
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003873:Dermatitis, Exfoliative / Q000139:chemically induced / Q000473:pathology; D004177:Dipyrone / Q000009:adverse effects; D003875:Drug Eruptions / Q000145:classification / Q000188:drug therapy / Q000473:pathology*; D004892:Erythema Multiforme / Q000139:chemically induced / Q000473:pathology; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D010406:Penicillins / Q000009:adverse effects; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced / Q000209:etiology / Q000473:pathology; D013449:Sulfonamides / Q000009:adverse effects; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects; D014581:Urticaria / Q000139:chemically induced / Q000473:pathology
D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D000995:Antitubercular Agents; D010406:Penicillins; D013449:Sulfonamides; D004177:Dipyrone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011239:Prednisolone