Cutaneous adverse drug reactions in a hospital-based Chinese population.
BACKGROUND
Cutaneous adverse drug reactions (CADRs) are common skin adverse reactions associated with drugs.


OBJECTIVE
To assess recent trends in CADRs and the drugs associated with them, using data from the past 5 years in the largest single database available on a hospital-based population in China.


METHODS
All clinical records of inpatients admitted with a diagnosis of CADR to the Dermatology Ward, Huashan Hospital from January 2004 to December 2008 were retrospectively studied.


RESULTS
In the 734 patients, the three most common types of CADRs were nonsevere reactions, erythema multiforme (EM)-like eruptions (n = 255), urticaria (n = 192) and exanthematous reactions (n = 159), followed by three severe reactions: Stevens-Johnson syndrome (n = 58), toxic epidermal necrolysis (n = 29) and exfoliative dermatitis (n = 22). The most common single drug associated with the development of all drug eruptions was allopurinol, followed by amoxicillin, cephalosporins, antiepileptic agents and antipyretic/analgesic agents. However, the most common single drugs associated with severe reactions were antiepileptic agents, followed by allopurinol, antipyretic/analgesic agents and cephalosporins. In contrast to patients with nonsevere reactions, patients with severe reactions were more likely to be male (P < 0.001) and to have a greater mean age of onset (P < 0.001), a longer latency period (P < 0.001) and a longer duration of hospitalization (P < 0.001).


CONCLUSIONS
In contrast to previous studies, we found allopurinol to be the most common single drug associated with CADRs followed by antibiotics (amoxicillin and cephalosporins), and antiepileptic, especially carbamazepine. A higher incidence of EM-like eruptions and urticaria was also seen.
Huang
H-Y
HY
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Luo
X-Q
XQ
Chan
L-S
LS
Cao
Z-H
ZH
Sun
X-F
XF
Xu
J-H
JH
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects; D000700:Analgesics / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D002648:Child; D002681:China / Q000453:epidemiology; D003875:Drug Eruptions / Q000453:epidemiology / Q000209:etiology*; D004892:Erythema Multiforme / Q000139:chemically induced / Q000453:epidemiology; D005076:Exanthema / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006074:Gout Suppressants / Q000009:adverse effects; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D014581:Urticaria / Q000139:chemically induced / Q000453:epidemiology; D055815:Young Adult
D000700:Analgesics; D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D006074:Gout Suppressants; D000493:Allopurinol