Volume 13 Issue 3
Exploring Cutaneous Adverse Drug Reactions: Uncovering Mechanisms and Risk Factors to Enhance Patient Safety
1Dr Mujeeb ur Rehman, 2Dr Talha Khan, 3Dr. Sulman Shoukat, 4Dr Sohaib Safdar, 5Dr Muhammad Burhan Javid, 6Dr Rimsha Rameen
1Resident Rheumatology, Pakistan institute of Medical Sciences
2Medical SHO, Letterkenny University Hospital,Ireland
3House officer, Aziz Bhati Shaheed Teaching hospital,Gujrat
4Student at Rai Medical College Teaching hospital Sargodha
5 Student at Rai medical college teaching hospital Sargodha
6Medical Officer,Ali Fatima Hospital, Lahore
Corresponding Author: Dr Wareesha Bint E Fayyaz
Hospital countess of chester
ABSTRACT
Background: Adverse drug reactions (ADRs) affecting the skin can range from mild rashes to severe life-threatening conditions such as Stevens-Johnson syndrome. Identifying the underlying mechanisms and risk factors associated with these reactions is crucial for improving patient safety and optimizing drug therapy.
Aim: This study aimed to investigate the mechanisms and risk factors contributing to cutaneous ADRs to enhance early detection and prevention strategies.
Methods: A prospective observational study was conducted at Services Hospital, Lahore, from October 2023 to September 2024. A total of 50 patients who developed skin-related ADRs were included. Clinical assessments, detailed medication histories, and laboratory investigations were performed to determine potential drug culprits and underlying mechanisms. The severity of reactions was classified using the Naranjo Adverse Drug Reaction Probability Scale.
Results: Among the 50 participants, 60% were female and 40% were male, with a mean age of 42.3 ± 11.7 years. The most frequently implicated drug classes were antibiotics (40%), nonsteroidal anti-inflammatory drugs (NSAIDs) (28%), and antiepileptics (18%). The most common manifestations included maculopapular rashes (46%), urticaria (22%), and fixed drug eruptions (18%), while severe reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis accounted for 8%. Risk factors identified included a history of previous drug reactions (34%), polypharmacy (48%), and underlying autoimmune disorders (20%). The majority of cases (72%) were classified as probable ADRs according to the Naranjo Scale, while 18% were deemed definite.
Conclusion: Skin-related ADRs were predominantly associated with antibiotics, NSAIDs, and antiepileptic drugs. Polypharmacy and a history of previous drug reactions significantly increased the risk. Early identification of high-risk individuals and judicious drug prescribing are essential for preventing severe outcomes. These findings underscore the importance of pharmacovigilance and patient education to improve medication safety.
Keywords: Adverse drug reactions, cutaneous toxicity, pharmacovigilance, risk factors, drug safety, Stevens-Johnson syndrome.