Spectrum of severe cutaneous adverse drug reactions among pediatric population and management options

Abstract

Background: Cutaneous adverse drug reactions (CADRs) have been seen to be one of the most common adverse drug reactions in various studies, and the incidence in developing countries is thought to be higher between 2% and 5%. Moreover, severe CADRs (SCADRs) constitute 2% of all CADRS and can be life-threatening. The pediatric population too is vulnerable, and like in adults, SCADRs are associated with serious mortalities and morbidity; hence, early diagnosis and prompt treatment are the cornerstone for better survival. Objective: This study was undertaken to assess the patterns of SCARDs among pediatric patients and to identify the causative drug/drugs and establish causality using Naranjo scale and also study various treatments given including the role of corticosteroids in their management. Materials and Methods: A total of 52 pediatric patients (Results: A total of 52 patients were taken up for the study. The youngest was 9 months old, whereas the oldest was 18 years old. There were 34 (65.3%) males and 18 (34.6%) females. The most common SCADR was SJS seen in 27 (51.9%), followed by TEN in 9 (173%), SJS-TEN overlap in 8 (15.3%), DRESS in 6 (11.5%), and AGEP in 2 (3.8%). Conclusion: There is a lack of studies on SCADRs among the pediatric population and more so dilemma still exists regarding management. Thus, multiple such studies need to be carried out to establish clear-cut recommendations for the management of SCADRs in children and also to assess the role of corticosteroids in their management, particularly in a resource-poor nation like India.