Cyclosporine - An eye opener in severe cutaneous adverse drug reactions
Journal Title: IP Indian Journal of Clinical and Experimental Dermatology - Year 2018, Vol 4, Issue 1
Abstract
Severe cutaneous adverse drug reactions sCADR comprise the lifethreatening Stevens Johnson Syndrome SJS Toxic Epidermal Necrolysis TEN and Drug Reaction with Eosinophilia and Systemic Symptoms DRESSAim The aim of this study was to assess the efficacy and safety of cyclosporine in treating sCADRMaterials and Methods A retrospective study was done from data collected over a three year period at the department of dermatovenereoleprology at a tertiary care centre in South India Out of thirtyfour inpatients with adverse drug reactions ADRs twenty who fulfilled the inclusion criteria one DRESS ten SJS and nine TEN patients were taken for the study Fixed drug eruption and TEN with multiorgan failure were excludedMethodology Patients were evaluated screened for multiorgan involvement offending drugdrugs were withheld routine investigations done and the severity assessed based on SCORTEN Treatment was initiated with injection dexamethasone 1mgkgday and supportives In those with unsatisfactory response in three days if not contraindicated oral cyclosporine was added at a dose of 100mg bid for 2 weeks tapered by 50mgweek and stopped once the lesions healed Efficacy of cyclosporine was assessed using the average number of stabilization days the rate of cutaneous reepithelialization and the duration of hospitalizationResults For SJS the mean duration of stabilization was 2 days reepithelialization 79 days and hospitalstay 181 days For TEN the mean duration of stabilization was 39 days reepithelialization 128 days and hospitalstay 292 daysConclusion With the use of cyclosporine patients stabilized early reepithelialization occurred early concomitant use with steroids helped in early tapering of steroid dose Recovery time and duration of hospital stay were shortened Cyclosporine was well tolerated no significant toxicity was noted there was no mortalityKeywords Cyclosporine Severe cutaneous adverse drug reactions DRESS SJS TEN
Authors and Affiliations
V. Anandan, P. S. Mohana Sundari, Yoga Nandhini, Ragini Rajan
Keywords
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- EP ID EP488950
- DOI 10.18231/.2018.0011
- Views 129
- Downloads 0
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