Aetiopathogenesis of severe cutaneous adverse reactions (SCARs) in children: A 9-year experience in a tertiary care paediatric hospital setting.
Clin Exp Allergy
; 50(1): 61-73, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31608511
ABSTRACT
BACKGROUND:
Severe cutaneous adverse reactions (SCARs) are delayed-type hypersensitivity reactions to drugs including as follows Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and Acute Generalized Exanthematous Pustulosis (AGEP). Incidence, triggers and management of SCARs have not been investigated in large-scale epidemiological studies on children.OBJECTIVE:
The aim of our study was to collect epidemiological, clinical and aetiological data from children with SCARs referred to our tertiary care paediatric hospital of Florence.METHODS:
From 2010 to 2018 charts of children with diagnosis of SCAR were reviewed, and data collected during the acute phase and/or the subsequent allergy evaluation. Patients underwent patch tests, intradermal tests and lymphocyte transformation tests. All children were investigated for infectious diseases.RESULTS:
Incidence of SCARs in hospitalized children was 0.32% over a 9-year period. Fifty-four children were enrolled (31 M; 23 F; median age 6.5 years) 17 cases of DRESS, 30 SJS, 3 TEN, 2 AGEP, 1 linear immunoglobulin A bullous disease (LABD) and 1 pemphigus. Twenty-eight out of 54 patients underwent drug allergy investigations, and 50% of them resulted positive. Combining clinical history and results of allergy work-up, 74% SCARs seem to be caused by drugs, 18.6% by both drugs and infections, 3.7% by infections, and 3.7% remained idiopathic. No deaths occurred.CONCLUSIONS:
In this study, SCARs incidence is in line with literature data. Drugs were most commonly the leading cause. Management of SCARs requires cooperation among professional figures for an early diagnosis and a prompt treatment. Mortality rate seems to be lower in children.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Anti-Inflamatórios não Esteroides
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Síndrome de Stevens-Johnson
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Pustulose Exantematosa Aguda Generalizada
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Síndrome de Hipersensibilidade a Medicamentos
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Antibacterianos
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Anticonvulsivantes
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article