Abstract
A retrospective study was performed at Yokohama City University Hospital using medical records of patients with cutaneous adverse drug reactions (CADR) from April 2003 to March 2009. In total 341 patients were analyzed for clinical features and causative drugs. The two major causative drugs were antibiotics (29%) and anti-cancer drugs (18%). Among the causative anti-cancer drugs, we recorded a greater number of molecular target drugs than reported in previous studies. Although macropapular rash was the most common reaction, as reported previously, patterns of clinical manifestation differed from those previously recorded. Notably, in patients treated with anti-cancer drugs, localized macropapular rash, hand-foot syndrome, and severe acneciform eruption were seen. The severe types of CADR, Stevens-Johnson syndrome/toxic epidermal necrolysis and drug-induced hypersensitivity syndrome, accounted for 6% and 2%, respectively, of CADR types. Positive reactions with causative drugs were observed in 34%, 68%, and 60% of patients as determined by patch, intradermal, and drug-induced lymphocyte stimulation tests, respectively. Almost 80% of patients were cured after discontinuing the causative drugs without any general treatments, including steroids, or could continue the drugs with just topical therapies. Clinical manifestations of CADR are changing with changing drug therapies. It is therefore important to continue clinical analysis of CADR.
