Prevalence and types of cutaneous drug reactions in two institutes

Abstract

Introduction: Adverse drug reaction is one of the growing concerns of today’s health practice. The purpose of the study was to find out the prevalence and types of cutaneous drug reactions at Tribhuvan University Teaching Hospital (TUTH) and DI Skin Hospital and Research Centre.

Methods: It was a prospective, crosssectionalstudy conducted at Department of Dermatology of TUTH and DI Skin Hospital and Research Centre from 14 th April 2010 to 14 th October 2010. All the suspected cases of cutaneous drug reaction above 14 years were included. Naranjo Algorithm was used to establish the causality and Modified Hartwig and Siegel Scale was used to access the severity of the cutaneous drug reaction. Clear purpose of the study was described and a patient consent form was produced before them while collecting the data and ethically approved from Institutional Review Board, Institute of Medicine.

Results: Prevalence of cutaneous drug reaction was found to be 0.258%. The male: female ratio was 2.1:1. The highest percentage of CDR was seen in 15-34 years age group. Antibiotics were the group of drug involved in most CDR followed by anticonvulsant. Phenytoin, ibuprofen+paracetamol combination and betamethasone were mostly associated with CDR. 51.61% of the cases were of moderate III rd level which was followed by moderate IV (b) level. 51.62% were assessed to be probable and 48.38% were possible. Out of 13 admitted cases, 6 cases were admitted for 7-9 days. Maculopapular rash was the most common clinical presentation observed followed by Steven’s Johnson Syndrome.

Conclusion: The study estimated the average rate of cutaneous drug reaction in two major hospitals of Nepal. It also determined the most common type of manifestation of the cutaneous drug reaction.