| Author |
Dong Yoon Kang, James Yun, Suh-Young Lee, Young-Il Koh, Da Woon Sim, Sujeong Kim, Young Hee Nam, Jung-Won Park, Sae Hoon Kim, Young-Min Ye, Hye-Kyung Park, Min-Hye Kim, Young-Koo Jee, Jae-Woo Jung, Min-Suk Yang, Sang-Heon Kim, Jun Kyu Lee, Cheol-Woo Kim, Gyu Young Hur, Mi-Yeong Kim, Seoung Ju Park, Yong Eun Kwon, Jeong-Hee Choi, Joo-Hee Kim, Sang Hyon Kim, Hyen O. La, Min-Gyu Kang, Chan Sun Park, Sang Min Lee, Yi Yeong Jeong, Hee-Kyoo Kim, Korean Severe Cutaneous Adverse Reactions Consortium
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| Abstract |
Background: Because severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) rarely occur, clinical data based on large-scale studies are still lacking.
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.
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