2024 Volume 41 Issue 1 Pages 46-
Approximately 5700 patients came to our dermatology clinic in the past 27 months (2020-2022). Sixty-four out of 5700 patients were diagnosed as toxic eruption. The incident rate was 1.1%. These toxic eruption patients were classified into following six groups, group A: drug-induced type, B: idiopathic or infection-induced type, C: unclear drug/infection-induced type, D: a type developed after removal of Helicobacter pylori, E: a type developed after injection of contrast medium, F: rubella suspected patients. The highest percentage of toxic eruption was seen in group B at 50%, followed by group A and C at about 15% each. Total percentage of these three groups accounted for more than 80% of whole toxic eruption patients. Oral lesions were frequently observed in group B patients (hairy tongue: 81%, tonsillar redness and swelling: 90%) in contrast to the control group (25%, 50% respectively), suggesting possible relations between oral lesion and the development of toxic eruption. To find some facile laboratory data which might prospect worsening case of toxic eruption, we compered CRP (C-reactive protein) and LDH (Lactate dehydrogenase) levels of mild case including groups B and C with those of sever cases, such as SJS (Stevens-Johnson syndrome), TEN (Toxic epidermal necrolysis) or DIHS (Drug-induced hypersensitivity syndrome) from reported articles. In severe cases, the positivity rate of CRP and LDH were both high (90%, 71% respectively), compared to our mild cases (11% and 21%). Considering the facts that CRP levels are closely related the amount of IL-6 and that IL-6 exacerbates local underlying inflammation through promoting cytokine storm, the increase of serum CRP levels may be used as a predicting marker for severe toxic eruption.
