J Asthma Allergy Clin Immunol.
2000 Jun;20(3):517-527.
Clinical review and skin test of patients with drug eruption
- Affiliations
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- 1Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract
- BACKGROUND
Drug eruption is a relatively common disorder and may cause significant problems. Nevertheless, there have only been a few clinical studies of drug eruption in Korea.
OBJECTIVE
The purpose of this study was to define the clinical features and causative drugs of drug eruption, and to evaluate the diagnostic value of skin test and provocation test.
METHODS
We reviewed clinical data and laboratory results from 161 patients with drug eruptions. Furthermore, we performed skin test and provocation test on 12 and 8 patients, respectively.
RESULTS
The common clinical types were fixed drug eruption (31%), exanthematous eruption (29.8%), urticaria (9%), and EM/Stevens-Johnson syndrome/TEN (5%). The mean latent period was 14.1 days, varying from 3.6 days for fixed drug eruption to 175 days for lichenoid eruption. The major causative drugs were antibiotics (23.6%), common cold remedies (20.5%), nonsteroidal antiinflammatory drugs (10.6%), and herb medication and health foods (5.6%). The evaluation of the frequencies of drug eruption revealed 43.5% of the patients with one attack, and 32% of the patients be more than two attacks. The common underlying diseases were upper respiratory infection (26.7%), postoperative prophylactic medications (15.0%), infections (14.3%), and gastrointestinal troubles (6.2%). The skin test was positive in 5 of 12 patients (41.7%), and provocation test was positive in 2 of 8 patients (25%). Among the clinical types of drug eruption, EM/Stevens-Johnson syndrome/TEN had the earliest onset (25 years) and pustular type showed the latest onset (49.1 years). Females were more commonly affected than males in exanthematous type (2.7:1) and EM/Stevens-Johnson syndrome/ TEN (3:1). Comparing frequencies of drug eruption, fixed drug eruption and urticarial type showed higher frequencies than other types.
CONCLUSION
Although there were some limitations in estimating the values of skin test and provocation test in this study, they still remain the most reliable methods for evaluating drug eruption.
