A Study on Cutaneous Adverse Drug Reactions:Clinical Pattern and Causative Agents

Cutaneous eruptions are the most frequently reported adverse reactions to drugs. The pattern of cutaneous adverse drug reactions (ADRs) and the causative drugs keep changing every year.

The study was designed to ascertain the different clinical pattern of cutaneous ADRs and to determine the causative agents. A prospective hospital based study was carried out over a period of one year. The cutaneous ADRs of outpatients in the Department of Dermatology and inpatients transferred from other departments were recorded. Naranjos algorithm was used to determine the causality assessment. A total of 150 patients diagnosed to have cutaneous ADRs were included in the study. The most common type of cutaneous ADRs were maculopapular rash (34.7%), followed by urticaria (12.7%) and acneiform eruptions (10%). Antimicrobial agents (40.7%) were responsible for majority detected adverse drug reactions, followed by nonsteroidal anti-inflammatory drugs (18.7%), anticonvulsants (12%) and antihypertensives (10.7%). Altogether 146 reactions had probable and 4 reactions had possible causal association with the drug. A wide clinical spectrum of cutaneous ADRs ranging from mild maculopapular rash to serious Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) were observed. Most of these drug eruptions were caused by antimicrobial agents. The occurence of cutaneous ADRs in the present study was in concurrence to various studies conducted in India.