Decoding dermatologic dilemmas: Assessment of cutaneous adverse drug reactions at a tertiary care hospital in South India - A retrospective study

• Author Details:   
• Nafeesath Jafna
• Dhivya Palaniappan ^*
• Seethalakshmi Ganga Vellaisamy
• Navakumar Manickam
• Kannan Gopalan

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Background: The incidence of adverse cutaneous drug reaction (cADR) varies from 2-3% among hospitalized patients. Around 2% of all cADR may be severe and end in fatalities.

cADR can range from mild, exanthematous rash to severe, life-threatening reactions.

Objective: This study aimed to draw association between potential offensive drugs and the ensuing cutaneous adverse reactions, and to assess the various morphological patterns and severity of reported adverse reactions.

Materials and Methods: This was an observational study conducted between ­­­­February 2023 and March 2024 in a tertiary care hospital in Tamil Nadu. A total of 63 patients with cADR were evaluated for a period of one year. Detailed history, clinical examination and relevant investigations, along with treatment outcomes were analysed.

Results: We noted a wide spectrum of cADR ranging from maculopapular eruption and fixed drug eruption to severe cutaneous adverse reactions (SCARs) like SJS/TEN. Antimicrobials were identified as the major factor associated, followed by NSAIDs. The most common presentation of cADR was fixed drug eruption (46%) followed by maculopapular eruption (17.5%). SCARs accounted for 26.9% of the total cADR in our study. SJS/TEN overlap (12.7%) was the most common SCAR we observed in our study, the most frequent drugs implicated in SCAR were antiepileptics (25%).

Conclusion: The most common cADR observed in this study was FDE and antibiotics were the most commonly associated agents.