Fundación Valle del Lili, Universidad Icesi, Cali, Colombia.
Hospital Universitario Austral, Buenos Aires, Argentina.
J Investig Allergol Clin Immunol. 2021 Jul 26;31(4):322-331. doi: 10.18176/jiaci.0497. Epub 2021 Feb 26.
Severe cutaneous adverse reactions to drugs (SCARs) are associated with high morbidity and mortality and with sequelae. Objective: To characterize patients with SCARs in 8 health care institutions in Latin America.
We performed a cross-sectional, descriptive, multicenter study of patients diagnosed with SCARs in Latin America between January 2009 and December 2018. The analysis was carried out using a database in BD Clinic.
We collected 70 patients, of whom 42 (60%) were women. Mean age was 38.7 years. Forty-two patients (60%) had DRESS-DIHS, 12 (17.1%) TEN, 5 (7.1%) SJS, 6 (8.5%) AGEP, 4 (5.7%) other reactions not classified as SCARs, and 1 (1.4%) overlapping SJS-TEN. The main causative drugs were aromatic anticonvulsants in 31 cases (44.3%), ß-lactam antibiotics in 11 cases (15.7%), and non-ß-lactam antibiotics in 6 cases (8.6%). In all of the cases, the suspected drug was withdrawn at the first sign of a SCAR. Sixty-six patients (94.2%) received anti-inflammatory treatment, mostly systemic corticosteroids. Complications occurred in 53 cases (75.7%), and 3 patients died (4.3%). Thirteen patients (18.6%) had sequelae.
This is the first multicenter report on SCARs in Latin America. DRESS-DIHS was the most frequently reported clinical entity, and anticonvulsants were the main triggers. Most of the patients received systemic corticosteroids. Complications were frequent, and 3 patients died.
药物严重皮肤不良反应（SCARs）与高发病率和死亡率以及后遗症有关。目的：描述拉丁美洲 8 家医疗机构中 SCARs 患者的特征。
我们进行了一项跨中心、描述性、多中心研究，纳入了 2009 年 1 月至 2018 年 12 月期间拉丁美洲诊断为 SCARs 的患者。分析使用了 BD Clinic 中的数据库。
我们共收集了 70 例患者，其中 42 例（60%）为女性。平均年龄为 38.7 岁。42 例（60%）为 DRESS-DIHS，12 例（17.1%）为 TEN，5 例（7.1%）为 SJS，6 例（8.5%）为 AGEP，4 例（5.7%）为其他未分类的 SCARs，1 例（1.4%）为重叠的 SJS-TEN。主要致病药物为 31 例（44.3%）芳香抗惊厥药、11 例（15.7%）β-内酰胺类抗生素和 6 例（8.6%）非β-内酰胺类抗生素。所有病例均在出现 SCAR 迹象时停用可疑药物。66 例（94.2%）患者接受了抗炎治疗，主要是全身皮质类固醇。53 例（75.7%）出现并发症，3 例死亡（4.3%）。13 例（18.6%）有后遗症。
这是拉丁美洲首例关于 SCARs 的多中心报告。DRESS-DIHS 是最常见的临床实体，抗惊厥药是主要的触发因素。大多数患者接受了全身皮质类固醇治疗。并发症常见，3 例死亡。
