A Clinical Retrospective Analysis Of 36 Cases With Severe Drug Eruption

ObjectiveTo study the clinical manifestation and prognosis of severe cases with drug eruption.MethodsA retrospective analysis was carried out on the clinical data of all patients suffered from drug eruption admitted into our hospital during the six years from January 2003 to December 2008.ResultThere were 36 patients who experienced severe drug eruption. Among them, there were 17 cases of erythema multiforme major, 12 cases of exfoliative dermatitis and 7 cases of toxic epidermal necrolysis. These predominant causative drugs included allopurinol, carbamazepine, penicillins and cephalosporins, antipyretics and analgesics,Chinese traditional medicine and so on. Allopurinol, carbamazepine were the most common causative drugs, which accounted for (10/36) 27.8% and (5/36)13.9% among all the causative ones respectively. These patient were from 20 to 79 years old and the most frequent age period was from 50 to 70 years old. Allopurinol-induced severe drug eruption had the longest latent period and severe symptom. Severe organs involved were also very common in the patients with severe drug eruption. TEN should be given more concern as it had the longest rash-controlling time and requires the largest dosage of corticosteroid for the effective treatment while ED is one of most severe durg eruptions with high reiteration of the illness. It is important to give suficient corticosteroid earlier. Intravenous immunoglobulin combined with corticosteroid was a good treatment option for some severe cases when the treatment with large dose of corticosteroid didn't work or patients with other systemic diseases.ConclusionSevere drug eruption with organs involved usually developed very fast; It is important to give suficient corticosteroid earlier and add gammaglobulin if necessary. It was recommended to treat with corticosteroid combined with intravenous immunoglobulin. It is suggested that the prognosis is determined by the duration from eruption onset to the start of treatment and treatment measure, the dosage of systemic corticosteroid , IVIG therapy, the age of the patient, the type of drug eruption, the organs invovled, the involving scopes of the skin and mucosa , previous diseases and medical nursing.