Abstract

EPIDERMOLYTIC ADVERSE CUTANEOUS DRUG REACTIONS DUE TO SYSTEMIC ANTIBIOTICS – ONSET AND MUCOUS MEMBRANES' AFFECTION

Ietimad Abdelsalam Mohamed Ayed and Mohammed Helmy Faris Shalayel*

Abstract

A wide spectrum of cutaneous manifestations ranging from maculopapular rashes to toxic epidermal necrolysis (TEN), considered being two ends of a spectrum of severe epidermolytic adverse cutaneous drug reactions can be caused by different classes of antibiotics. Toxic epidermal necrolysis (TEN) and Stevens Johnson Syndrome (SJS) are characterized by mucocutaneous tenderness and typically hemorrhagic erosions, erythema and more or less severe epidermal detachment presenting as blisters and areas of denuded skin. Our prospective descriptive hospital -based study aimed to determine the prevalence of epidermolytic adverse cutaneous drug reactions among other cutaneous adverse drug reactions due to systemic antibiotics with highlights on onset and mucous membranes affection in Sudanese patients attended Khartoum Dermatology and Venereal diseases Teaching Hospital – Sudan. Mucous membranes' affection existed in 100 % of patients. Ocular along with oral mucosal affections were the predominant sites. Percentages of only oral affection, mouth and genitalia, mouth and eyes, eyes and genitalia, all mucous membranes, eyes alone, and genitalia alone were 34.1%, 22%, 14.6%, 12.2%, 12.2%, 2.4%, and 2.4%% respectively. Epidermolytic adverse cutaneous eruption represented 58.6% of all cutaneous drug reactions due to antibiotics. It was concluded that epidermolytic adverse cutaneous drug eruptions are common cutaneous adverse drug reactions (CADRs) and represented 58.6% of all cutaneous drug reactions due to antibiotics. Ocular along with oral mucosal membranes (41.5 % and 34.1%) were the predominant sites of mucosal affection. Onset of < 1 week after offending drug administration was seen in most of patients (53.7%).

Keywords: Cutaneous Adverse Drug Reactions (CADRs); Steven Johnson Syndrome (SJS); Toxic Epidermolysis Necrolysis (TEN); Erythema Multiforme (EM); Antibiotics.