drug-induced skin reactions characteristics in general emergency hospital

MY RUDYK. Russian Peoples’ Friendship University, propedeutics of internal diseases, 117198, Russia

Aims: To study the drug - induced skin reactions in general emergency hospital.

Material and Methods: This prospective study was carried out in a general emergency hospital in the departments of therapy, urology, and purulent surgery for 1 year (Jan. 2010 - Dec. 2010). During this time dermatologist has been examined about 1000 hospitalized patients with skin reactions of a various etiology. The group of 347 patients with skin reactions potentially associated with medication was selected. Two methods to identify patients with cutaneous reactions were used: a screening method and spontaneous reports.

Results: Analyses of information about of 347 patients with skin diseases of various etiologies, revealed that 179 of them (52%) had skin reactions which were not associated with taking drugs, and 168 (48%) had drug-induced skin reactions. There were 42% of men and 58% of women among patients with drug-induced skin reactions (n = 168). The main part of reports of the CDR (cutaneous drug reactions) came from medical departments. The most common types of CDR were: acute urticaria, angioedema (37%), drug toksikodermiya (32%), allergic dermatitis (11%). b-lactam antibiotics were responsible for 18% of the CDR, fluoroquinolones - 11%, improving cerebral blood flow – 7%, radio-opaque- 7%; uroseptik- over 6%. The suspected drug was not established in 13% cases According to the scale of Naranjo identified drug-induced skin reactions were: possible - 57%, probable - 35%. In 8% of cases, the causal link has not been established. The study showed that patients receiving 5 or more drugs at the same time were more susceptible to CDR. Burdened by drug allergic anamnesis observed in 31% of patients. 116 patients with CDR were revealed by screening method, and 52.- by spontaneous reports

Conclusions: Because the CDR are common among inpatients, it would be appropriate to conduct inspection of such patients by dermatologists. In addition, contemporary use of 2 methods of study will provide fuller and truly information about the CDR. Acute urticaria, angioedema, drug toksidermiya and allergic dermatitis are the most common drug-induced skin reactions. Advanced age, female sex, drug-laden allergic anamnesis, polypharmacy are risk factors for the development of the CDR. Penicillin’s, cephalosporin’s, fluoroquinolones are the most frequent.