Huang HY, Luo XQ, Chan LS et al.
Fudan University, Shanghai, China.
Clin Exp Dermatol 2011;36:135–41.
Editor’s note: The authors of this article conducted a retrospective analysis of the records of 734 patients who were admitted to Huashan hospital over a 5-year period with a cutaneous adverse drug reaction (CADR). They found that the number of CADRs increased each year, but the proportion of severe CADRs remained relatively constant, at 10.85–18.58%. They noted that the three most common types of CADRs were of a non-severe type and consisted of erythema multiform-like eruptions (n=255), urticaria (n=192), and exanthematous reactions (n=159). This was followed by three severe CADRs: Stevens–Johnson syndrome (n=58), toxic epidermal necrolysis (n=29), and exfoliative dermatitis (n=22). The most common drugs associated with the development of all CADRs were allopurinol, amoxicillin, cephalosporins, antiepileptics, and antipyretic/analgesic agents, in order of frequency. However, the most common causative drugs in severe CADR were antiepileptics, followed by allopurinol, antipyretic/analgesic agents, and cephalosporins. In this group, the antiepileptic agent most commonly implicated was carbamazepine, in 17 out of 20 cases. The authors also noted in their study that patients with severe CADRs were more likely to be male, had a lower mean age of onset (mean 18.4 years vs. 43.1 years), had a longer latency period (mean 12.4 days vs. 6.9 days ), and required a longer period of hospitalization compared with the non-severe CADR group. What was also interesting was that traditional Chinese medicines were also implicated and accounted for 10.4% of non-severe CADRs and 1.92% of severe CADRs, including one case of toxic epidermal necrolysis.