title: Severe cutaneous adverse reactions in a local hospital setting: a 5-year retrospective study.
abstract: BACKGROUND
  Severe cutaneous adverse reactions (SCAR) are rare but important causes of morbidity and mortality. Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) are severe cutaneous drug reactions that can be potentially life threatening. Our study aims to look at the epidemiology of SCAR in the local setting in Singapore and the underlying characteristics of our patients that may influence the drug reaction seen.
  
  
  METHODS
  Data was collected retrospectively from in-patient records in the period of January 2007 to December 2011. We looked at several factors: (i) patient demographics including age, gender, ethnicity, comorbidities, (ii) culprit drug(s), (iii) latent period, (iv) drug reaction observed, (v) systemic complications, (vi) length of hospital stay, (vii) treatment given, and (viii) outcomes (mortality, morbidity).
  
  
  RESULTS
  We collected data from 42 patients. The mean age of our patients was 51.8 years. Twenty-nine (69%) of the patients had underlying comorbidities. The most common culprit drug group was antibiotics. SJS was the most common SCAR observed (54.8%), followed by acute generalized exanthematous pustolosis (AGEP; 24%), TEN (11.9%), and DRESS (2%). Sixteen patients (38.1%) had complications, and there was one reported death. There was a weak correlation (correlation coefficient 0.29, P value = 0.15, 95% CI = 2.07) between early steroid therapy and the length of stay.
  
  
  CONCLUSIONS
  Antibiotics are the most common culprit drugs. The most common SCAR observed in our study was SJS. Early initiation of steroids may lead to a more favorable outcome.
authors: National University Hospital Singapore, Singapore.
authors: Peiqi
authors: P
authors: Su
authors: Chen Wee Derrick
authors: CW
authors: Aw
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D002648:Child; D015897:Comorbidity; D063926:Drug Hypersensitivity Syndrome / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006074:Gout Suppressants / Q000009:adverse effects; D006764:Hospitals, Community; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore; D013256:Steroids / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D006074:Gout Suppressants; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D013256:Steroids; D000493:Allopurinol