Retrospective Analysis Of 69 Cases With Severe Drug

Objective:This study discusses the spectrum of allergic drugs and drug eruption types in the last four years through a retrospective analysis on allergenic drugs, the incubation period, rash types, clinical characteristics, and treatment process of patients with severe drug eruption who were admitted in our hospital in the last four years, so as to provide the basis for guiding clinical medication.Methods:A retrospective analysis was performed on clinical data of 69 cases of patients with severe drug eruption who were hospitalized in dermatological departments of two grade-Ⅲ first-class hospitals in Kunming between 2011 and 2014.Results:Among 69 patients with severe drug eruption,32 cases (46.38%)were SJS,23 cases (33.3%) were TEN,10 cases (14.49) were DRESSand4 cases (5.8%) were ED. There were 33 male cases and 36 female cases, with the female-male ratio of 1:1.09. The onset age was from 3 to 85 years old, with an average age of (33.65±21.86) years.16 cases were children with severe drug eruption, where 8 cases were SJS and 8 cases were TEN. Among 53 adult patients,24 cases were SJS,15 cases were TEN,10 cases were DRESS and 4 cases were ED. Average incubation periods of SJS, TEN, DRESS and ED were 3.52±3.46d,6.74±13.06d,10.8±10.46d and 16.7±15.31d, respectively. There were statistical differences between SJS and DRESS as well as ED in incubation period (P<0.05), and statistical differences between DRESS and ED (P<0.05). Incubation period was 4.07±3.62d in children while 5.96±8.14 d in adults. Incubation period was longer in adults than children (P<0.05).Common allergenic drugs included:39 cases (48%) of antibiotics,18 cases (22%) of antipyretic and analgesic drugs, and 8 cases (10%) of antiepileptic drug. Antibiotic drugs causing drug eruption are mainly Beta lactam (61.54%).Antibiotics can easily cause SJS, while antiviral drugs often cause TEN.50 cases (72.47%) appeared mucosal involvement. Incidence of SJS mucosal involvement was highest while incidence of DRESS mucosal involvement was lowest. SJS type is more likely to appear mucosal damage than TEN type, and the differences were of statistical significance (p<0.05). 36 cases were accompanied with infection, mainly for skin infection (accounting for 33%), followed by pulmonary infection (accounting for 31%). There were no statistically significant differences between infection and non-infection group in fever (P>0.05). Hospitalization days were 15.6±6.20 in steroid group, and 10.8±5.13 in steroid+immunoglobulin group. There were statistically significant differences in comparison between two groups (p<0.05).Conclusion:In this study, SJS type is at most, followed by TEN and ED type is at least; antibiotic drugs are the major in allergic drugs, followed by antipyretic and analgesic drugs. Incubation period of SJS type is the shortest while that of ED type is the longest. Incubation period of children with severe drug eruption is shorter than adults. steroid+immunoglobulin group hospitalization days shorter than use hormone group.