MyMedR

Sodium valproate-aggravated psoriasiform eruption

Kwan Z, Che Ismail RB, Wong SM, Tan LL, Robinson S, Lim KS

Int J Dermatol, 2014 Oct;53(10):e477-9.

PMID: 25209632 DOI: 10.1111/ijd.12579

Matched MeSH terms: Drug Eruptions/etiology*

Skin lesions induced by penicillamine. Occurrence in a patient with hepatolenticular degeneration (Wilson Disease)

Greer KE, Askew FC, Richardson DR

Arch Dermatol, 1976 Sep;112(9):1267-9.

PMID: 136925

A 41-year-old patient with hepatolenticular degeneration (Wilson disease), who had been treated for 15 years with penicillamine, developed small white papules at sites of venipuncture in the antecubital fossae and at surgical suture sites. Histologically, these papules showed focal areas of connective tissue degeneration in the dermis, but there was no evidence of inclusion cysts. The changes most likely resulted from the effect of penicillamine on new connective tissue formation at the sites of injury. The patient also developed crinkling of the skin of her face and neck while on the penicillamine regimen, and these changes were attributed, at least in part, to the effects of this drug on connective tissue.

Matched MeSH terms: Drug Eruptions/etiology*

Fulltext Concurrent massive breast enlargement, myasthenia gravis and dermopathy as manifestations of penicillamine toxicity in a Wilson's disease patient

Tan SS, Latif SA, Poh WY

Med J Malaysia, 2012 Jun;67(3):323-5.

PMID: 23082426 MyJurnal

Penicillamine toxicity in Wilson's disease has been well reported but rarely seen now as newer agents are being used. We present a case who developed multiple rare complications of Penicillamine concurrently. Our patient is one of three siblings on Penicillamine, she was the only one who developed massive breast enlargement four months after commencing Penicillamine therapy, as well as dermatological adverse reactions and myasthenia gravis three more months later. All the adverse effects improved soon after substitution of the offending agent with Trientine.

Matched MeSH terms: Drug Eruptions/etiology*

Fixed drug eruption associated with co-trimoxazole

Mohamed KB

J Pediatr, 1999 Sep;135(3):396.

PMID: 10484812

Matched MeSH terms: Drug Eruptions/etiology*

Drug eruptions from phenylbutazone in Jamu

Giam YC, Tham SN, Tan T, Lim A

Ann Acad Med Singap, 1986 Jan;15(1):118-21.

PMID: 2939787

Drug eruptions from indeginous medicine is often difficult to diagnosis and confirm. It is known that a number of these now supplied by bomohs and Chinese sinsehs contain known drugs and are dispensed as tablets and capsules. We report 3 cases of adverse drug eruption to "Jamu", a Malay herb. A particular brand, "Jamu Indonesia, Toko Air Pancur", from Johor Bahru, Malaysia, is especially recommended for "sakit pinggang" or backache. The cases occurred between January and February 1985, and all had taken brown kidney shaped tablets. The adverse reactions were moderately severe. Two had erythroderma with hepatitis, and one, Steven Johnson Syndrome. Analysis of this jamu for analgesics led to the discovery of adulteration with phenylbutazone and diazepam. Records from local cases from 1974-1984 showed that 8 other patients, all Chinese had adverse cutaneous eruptions from phenylbutazone, oxybutazone and propyphenazone. The skin manifestations were erythroderma (2 cases), vasculitis (2 cases) and toxic epidermal necrolysis (4 cases). Those with toxic epidermal necrolysis had 100% mortality.

Matched MeSH terms: Drug Eruptions/etiology*

Oral fixed drug eruption due to tinidazole

Singh R, Ramachandra SS, Dayakara JK

Cutis, 2016 Dec;98(6):E1-E2.

PMID: 28099544

Matched MeSH terms: Drug Eruptions/etiology*

Fulltext Toxic epidermal necrolysis in Malaysian adults. A retrospective study

Ting HC, Adam BA

Singapore Med J, 1985 Oct;26(6):456-9.

PMID: 2937150

We report a retrospective study of all cases of toxic epidermal necrolysis admitted to the adult medical wards of the University Hospital in Kuala Lumpur over a 16 year period from 1967 to 1983. Over this period of time only 7 cases were encountered, suggesting the condition is rare in adults in our country. All the cases were females and the age ranged from 21 to 41 years. Four cases were due to drugs, 2 were idiopathic and one was attributed to Staphylococcal infection. One patient died. The other patients recovered completely with no sequelae.

Matched MeSH terms: Drug Eruptions/etiology

Incidence of cutaneous adverse drug reactions among medical inpatients of Sultanah Aminah Hospital Johor Bahru

Latha S, Choon SE

Med J Malaysia, 2017 06;72(3):151-156.

PMID: 28733562 MyJurnal

INTRODUCTION: Cutaneous adverse drug reactions (cADRs) are common. There are only few studies on the incidence of cADRs in Malaysia.

OBJECTIVE: To determine the incidence, clinical features and risk factors of cADRs among hospitalized patients.

METHODS: A prospective study was conducted among medical inpatients from July to December 2014.

RESULTS: A total of 43 cADRs were seen among 11 017 inpatients, yielding an incidence rate of 0.4%. cADR accounted for hospitalization in 26 patients. Previous history of cADR was present in 14 patients, with 50% exposed to the same drug taken previously. Potentially lifethreatening severe cutaneous adverse reactions (SCAR), namely drug reaction with eosinophilia and systemic symptoms (DRESS: 14 cases) and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN: 6 cases) comprise almost 50% of cADRs. The commonest culprit drug group was antibiotics (37.2%), followed by anticonvulsants (18.6%). Cotrimoxazole, phenytoin and rifampicin were the main causative drugs for DRESS. Anticonvulsants were most frequently implicated in SJS/TEN (66.7%). Most cases had "probable" causality relationship with suspected drug (69.8%). The majority of cases were of moderate severity (65.1%), while 18.6% had severe reaction with 1 death recorded. Most cases were not preventable (76.7%). Older age (> 60 years) and mucosal involvement were significantly associated with a more severe reaction.

CONCLUSION: The incidence of cADRs was 0.4%, with most cases classified as moderate severity and not preventable. The commonest reaction pattern was DRESS, while the main culprit drug group was antibiotics. Older age and mucosal membrane involvement predicts a severe drug reaction.

Matched MeSH terms: Drug Eruptions/etiology

Hypersensitivity reactions to high-dose co-trimoxazole in HIV-infected Malaysian and Scottish patients

Pakianathan MR, Kamarulzaman A, Ismail R, McMillan A, Scott GR

AIDS, 1999 Sep 10;13(13):1787-8.

PMID: 10509585

Matched MeSH terms: Drug Eruptions/etiology*

Cutaneous adverse drug reactions: A four-year audit from a district hospital in Johor, Malaysia

Kim HS, Tang MM

Med J Malaysia, 2018 12;73(6):397-399.

PMID: 30647211

Cutaneous adverse drug reactions (cADR) are common. However, only very few audits reported the clinical characteristics of cADR captured at district hospitals. We performed a 4-year audit on cADR reported to the Department of Pharmacy in Hospital Pakar Sultanah Fatimah between May 2012 and March 2016. It showed that the main adverse drug reaction (ADR) reporters were pharmacists (84.9%) where the majority of the reactions were clinical descriptions without dermatological diagnosis. Antibiotics (46.4%) were the commonest culprit drug followed by NSAIDs (22%). The most common reactions were immediate reactions, i.e. urticaria and angioedema contributing 55.7% of the cases; followed by maculopapular eruptions (41.8%). There were only six cases (1%) of severe cADR reported in this cohort. Reporting bias and the incomplete dermatological diagnosis were the main limitation of the reports.

Matched MeSH terms: Drug Eruptions/etiology

Penicillin allergy 1976: a review of reactions, detection and current management

Fellner MJ

Int J Dermatol, 1976 Sep;15(7):497-504.

PMID: 134974

Matched MeSH terms: Drug Eruptions/etiology

A second international co-operative investigation into thiacetazone side-effects. Rashes on two thiacetazone containing regimens

Ferguson GC, Nunn AJ, Fox W, Miller AB, Robinson DK, Tall R

Tubercle, 1971 Sep;52(3):166-81.

PMID: 4106401

Matched MeSH terms: Drug Eruptions/etiology*

Fulltext Cross-reactivity in AED-Induced Severe Cutaneous Adverse Reaction: A Case Report

Khor AH, Lim KS, Tan CT, Kwan Z, Ng CC

J Investig Allergol Clin Immunol, 2016;26(5):329-331.

PMID: 27763865 DOI: 10.18176/jiaci.0085

Matched MeSH terms: Drug Eruptions/etiology*

Fulltext An epidemiological and clinical analysis of cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia

Choon SE, Lai NM

Indian J Dermatol Venereol Leprol, 2012 Nov-Dec;78(6):734-9.

PMID: 23075643 DOI: 10.4103/0378-6323.102367

BACKGROUND: The prevalence, clinical patterns, and causative drugs of cutaneous adverse drug reactions (cADR) vary among the different populations previously studied.
AIM: To determine the prevalence, the clinical patterns of drug eruptions, and the common drugs implicated, particularly in severe cADR such as Stevens-Johnson Syndrome/Toxic epidermal necrolysis (SJS/TEN) and drug rash with eosinophilia and systemic symptoms (DRESS) in our population.
METHODS: We analyzed the database established for all cADR seen by the department of Dermatology from January 2001 till December 2010.
RESULTS: A total of 362 cADR were seen among 42 170 new clinic attendees, yielding an incidence rate of 0.86%. The most common reaction pattern seen was maculopapular eruption (153 cases) followed by SJS/TEN (110 cases) and DRESS (34 cases). Antibiotics was the most commonly implicated drug group (146 cases) followed by anticonvulsants (81 cases) and antigout drugs (50 cases). The most frequently implicated drug was allopurinol (50 cases). Carbamazepine, allopurinol, and cotrimoxazole were the three main causative drugs of SJS/TEN accounting for 21.8%, 20.9%, and 12.7%, respectively, of the 110 cases seen, whereas DRESS was mainly caused by allopurinol (15 cases). Mortality rates for TEN, SJS, and DRESS were 28.6%, 2.2%, and 5.9%, respectively.
CONCLUSIONS: The low rate of cADR with a high proportion of severe reactions observed in this study was probably due to referral bias. Otherwise, the reaction patterns and drugs causing cADR in our population were similar to those seen in other countries. Carbamazepine, allopurinol, and cotrimoxazole were the three main causative drugs of SJS/TEN in our population.
Study site: department of dermatology in Hospital Sultanah Aminah

Matched MeSH terms: Drug Eruptions/etiology

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