A Nationwide Study of Severe Cutaneous Adverse Reactions Based on the Multicenter Registry in Korea.
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Kang Dong Yoon, Yun James, Lee Suh-Young, Koh Young-Il, Sim Da Woon, Kim Sujeong, Nam Young Hee, Park Jung-Won, Kim Sae Hoon, Ye Young-Min, Park Hye-Kyung, Kim Min-Hye, Jee Young-Koo, Jung Jae-Woo, Yang Min-Suk, Kim Sang-Heon, Lee Jun Kyu, Kim Cheol-Woo, Hur Gyu Young, Kim Mi-Yeong, Park Seoung Ju, Kwon Yong Eun, Choi Jeong-Hee, Kim Joo-Hee, Kim Sang Hyon, La Hyen O, Kang Min-Gyu, Park Chan Sun, Lee Sang Min, Jeong Yi Yeong, Kim Hee-Kyoo, Jin Hyun Jung, Jeong Jae-Won, Lee Jaechun, Lee Yong Won, Lee Seung Eun, Kim Myoung Shin, Kang Hye-Ryun, Korean Severe Cutaneous Adverse Reactions Consortium
Аннотация
OBJECTIVE: To provide information on culprit drugs and clinical characteristics, including morbidity and mortality of SCARs based on a nationwide registry.
METHODS: SCAR cases that occurred from 2010 to 2015 were recruited to the Korean SCAR registry from 34 tertiary referral hospitals. Demographics, causative drugs, causality, and clinical outcomes were collected by reviewing the medical record.
RESULTS: A total of 745 SCAR cases (384 SJS/TEN cases and 361 DRESS cases) due to 149 drugs were registered. The main causative drugs were allopurinol (14.0%), carbamazepine (9.5%), vancomycin (4.7%), and antituberculous agents (6.3%). A strong preference for SJS/TEN was observed in carbonic anhydrase inhibitors (100%), nonsteroidal anti-inflammatory drugs (84%), and acetaminophen (83%), whereas dapsone (100%), antituberculous agents (81%), and glycopeptide antibacterials (78%) were more likely to cause DRESS. The mortality rate was 6.6% (SJS/TEN 8.9% and DRESS 4.2%). The median time to death was 19 days and 29 days in SJS/TEN and DRESS respectively, and 89.8% of deaths occurred within 60 days after the onset of the skin symptoms.
CONCLUSION: Allopurinol, carbamazepine, vancomycin, and antituberculous agents were the leading causes of SCARs in Korea. Some drugs preferentially caused a specific phenotype. The mortality rate of SCARs was 6.6%, and most of the deaths occurred within 2 months.