Severe adverse cutaneous drug eruptions: epidemiological and clinical features

Abstract

Adverse cutaneous drug reactions (ACDR) are common, and some can be lethal. The aim of our study was to discuss the epidemiological and clinical features of severe ACDR. We retrospectively analyzed 100 cases of ACDR from 1981 to 2007, collected in the Department of Dermatology of the La Rabta Hospital in Tunis, which is located in the north of Tunisia. Severity was defined on three criteria: hospitalization; visceral involvement; and severity markers. Characteristics of the 54 included cases were: women (70%); mean age: 44.8 years; responsible drugs: anticonvulsants (28%), antibiotics (28%), and nonsteroidal anti-inflammatory drugs (15%). The most common dermatoses were maculopapular rash (50%). We observed fever (76%), lymphadenopathy (31.5%), eosinophilia (35%), and visceral involvement (50%). Twelve patients died directly related to the ACDR. This study underlines the polymorphous clinical presentation of ACDR and the importance of researching some severity markers, which have important practical implications.