TITLE:
Severe Drug Eruption in Guinea Conakry
AUTHORS:
Mohamed Cissé, Thierno Mamadou Tounkara, Boh Fanta Diané, Mohamed Maciré Soumah, Moussa Keita, Fodé Bangaly Sako, Fodé Amara Traoré, Houleymatou Baldé, Aissata Dabo Camara, Alhousseine Doumbouya, Amara Camara
KEYWORDS:
Severe Drug Eruption
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.4 No.5,
December
11,
2014
ABSTRACT: Severe drug reactions are defined as
mucocutaneous complications secondary to systemic administration of drugs
likely to be life threatening. Our work was designed to determine the
evolutionary epidemiological and etiological characteristics of severe drug
reactions to the Department of Dermatology Venereology, at Donka Teaching
Hospital. A prospective descriptive study of all cases of severe drug reactions
received at the Department of Dermatology Venereology of the Donka Teaching
Hospital was conducted over a period of two years, from June 2009 to May 31,
2011. We identified 22 Stevens-Johnson syndrome, 13 Toxic Epidermal Necrolysis,
1 Stevens-Johnson syndrome Border Toxic Epidermal Necrolysis, 1 Drug Rash with
Eosinophilia and Systemic Symptoms and 2 Acute generalized exanthematous
pustulosis among 481 hospitalized patients, of whom 50 had consulted for drug
reactions, that is to say, a frequence of 10.40%. The Stevens-Johnson syndrome
accounted for 44%, the Stevens-Johnson syndrome Border Toxic Epidermal
Necrolysis 2%, Toxic Epidermal Necrolysis 26%, Drug Rash with Eosinophilia and
Systemic Symptoms 2% and Acute generalized exanthematous pustulosis 4% of drug
reaction. The female sex was predominant (28 women vs. 11 men), that is to say
71.59% vs. 26.21 with a sex ratio of 2.55. The average age of our patients was
29.72 years; the range of ages 21 - 40 years was the most affected (51.28%)
followed by 0 - 20 years (33.33%). The lethality rate was 9.09% (2/22) in the
Stevens-Johnson syndrome and 53.85% (7/13) in the Toxic Epidermal Necrolysis.
HIV infection was found in 17.95% (7/26) of our patients and 71.42% (5/7) of
the deceased. The drug accountability was established in 79.48%; the most
commonly implicated drugs in the Toxic Epidermal Necrolysis were sulfonamides
followed by ARVs (nevirapine) and anti TB (isoniazid); in the SJS sulfonamides
followed by salts of quinine and anti TB, the only case of DRESS was due to
quinine. No drug was found in 20.52% (8 cases). HIV infection remains a poor
prognostic factor. Our study shows the scarcity of Drug Rash with Eosinophilia
and Systemic Symptoms and Acute generalized exanthematous pustulosis in our
service.