Drug-induced skin events in hospitalized patients in Tehran, Iran: a 6-year case series study

Introduction:
Drug reactions are commonly seen in the skin but their frequency has not been determined in Tehran yet. We aimed to evaluate adverse cutaneous drug events (ACDE) in hospitalized patients.
Material and methods: A 6-year case series study (from 2000 to 2006) including all hospitalized patients in two referral dermatology wards of Loghman-Hakim and Shohada Hospitals was performed.
Results: A total of 54 patients (31 female and 23 males) were included. Adverse cutaneous drug events was slightly more frequent in females (1.34 : 1). Thirty three and 22% of the patients were in the age group of 31-40 and 41-50, respectively. The most commonly seen dermatoses were maculo-papular rashes (60%), erythroderma (10%), and urticaria (10%). Drugs most frequently associated with ACDE were anticonvulsants and antibiotics, with rates of 31 and 28%, respectively. No mortality due to ACDE was seen. In most of the patients (50%), the duration of hospitalization was 3-7 days. Most of the patients (74%) had no previous history of allergy. In most cases (65%), the adverse events began during the first day to first month after drug exposure.
Conclusions: Although the prevalence of ACDE in this study was found to be lower than reported data in the literature suggest, the results confirm that ACDE is a notable public health concern. Early and rapid recognition of severe ACDE and prompt withdrawal of the offending drug are the most important actions to minimize morbidity associated with drug use.