Abstract

Research Article

Drug Eruptions at Patients in Consultation at the Dermatology Department of the Dermatology Teaching Hospital in Bamako, Mali: Epidemiological, Clinical and Etiological Study

Yamoussa Karabinta*, Mamadou Gassama, Aboubakar Hemedi Gassama, Adama Dicko, Hawa Sanogo, Karambe Tenin, Chata Traoré, Mamourou Diakité, Chaka Koné, Sounkalo Dao, Yannick Mukendi, Moussa Savané and Faye Ousmane Faye

Published: 28 April, 2021 | Volume 5 - Issue 1 | Pages: 013-017

The administration of a drug substance is an essential step in the management of a patient. It aims either to cure the patient, to prevent a given disease or sometimes to help with the diagnosis. Unfortunately, the action of the drug can go beyond the desired effect, and cause skin-mucous accidents. These accidents, also known as drug-induced attacks, can be isolated or associated with systemic manifestations [1]. Drug eruption is a real public health issue because of the high frequency. In Europe, drug eruption is responsible for about 20% of spontaneous reports of drug accidents. They complicate 2% to 3% of hospital treatments and motivate 1% of consultations, 5% of hospitalizations in dermatology [2]. Some African authors were interested in the subject. Reported prevalence in hospital settings ranges from 0.4% to 1.53% [3,4]. In Mali, there are no national figures. Old statistics from the Department of Dermatology show that about thirty cases occur each year, most of which are represented by severe forms. However, the risk of drug eruption is thought to be very high due to increased local use of drugs without medical advice, the illegal proliferation of drug outlets (‘Street Medicine’). And the lack of enforcement of existing regulations. In addition, some authors believe that the advent of antiretrovirals and the use of antiInfectious infections used to treat opportunistic infections have increased the risk of Drug eruption by 4 to 30 times, particularly in subjects infected with the acquired human immunodeficiency virus (HIV) [2]. This same risk can be observed in leprosy patients on combination chimotherapy. Clinically, the diagnosis of drug eruption is not as easy as one might think because of clinical polymorphism. The responsibility of a drug for the onset of a reaction is also not easy to establish, as in most cases several drugs are administered simultaneously before the onset of the rash. Because of illiteracy, patients find it difficult to make a complete list of the molecules consumed. To this must be added the high frequency of counterfeit medicines circulating both on the street and in private pharmacies. Given the scarcity of African studies and due to local specificities, it seemed interesting to us to undertake a study on Drug eruption in the dermatology department of the Dermatology teaching hospital of Bamako whose purpose is to study epidemiological aspects, clinical, etiological and to identify the molecules responsible in these patients.

Read Full Article HTML DOI: 10.29328/journal.adr.1001015 Cite this Article Read Full Article PDF

Keywords:

Psoriasis; Children with psoriasis; TT; TC and CC TaqI (T/C) genotypes of the VDR gene; Vitamin D serum level; PASI; PGA and BSA indices of psoriasis severity

References

  1. Privat Y. Toxidermies médicamenteuses, diagnostic et prévention. Ann Dermatol Venereol. 2003; 130: 159-153.
  2. Roujeau JC, Wolkenstein P. Réactions cutanées aux médicaments. In Dermatologie et infections sexuellement transmissibles ; 4èmeé dition Masson. Paris. 2000; 385-392.
  3. Ramorasata JA, Raveloson NE, Tohaina D, et al. Caractéristiques épidémio-cliniques des nécrolyses épidermiques toxiques dans le service de réanimation de l’Hôpital de Soavinandriana Antananarivo. Rev Anest Réa Urg. 2009; 1: 21-25.
  4. Atadokpede F, Yedomon H, Adegbidi H, Sehonou JJ, Azondekon A, et al. Mucocutaneous manifestations of human immunodeficiency virus infection in Cotonou, Benin. Med trop. 2008; 68: 273-276. PubMed: https://pubmed.ncbi.nlm.nih.gov/18689320/
  5. Begaud B, Evreux JC, Jouglard J, G Lagier. Imputation of the unexpected or toxic effects of drugs. Actualization of the method used in France. Therapie. 1985; 40: 111-118. PubMed: https://pubmed.ncbi.nlm.nih.gov/4002188/
  6. Safiatou I. Réactions cutanéo-muquqeuses d’origine médicamenteuse, thèse de médicine Fmpos n°07M197.
  7. Özkaya E. Specific site involvement in fixed drug eruption. J Am Acad. Dermatol. 2003; 49: 1003-1007. PubMed: https://pubmed.ncbi.nlm.nih.gov/14639376/
  8. Harugeri BM, Sanmukhani J, Patel T, Paliwal N, Shah H, Tripathi C, et al. Drug induced Stevens - Johnson syndrome, toxic epidermal necrolysis, and SJS-TEN overlap: A multicentric retrospective study. J Postgrad Med. 2011; 57: 115-119. PubMed: https://pubmed.ncbi.nlm.nih.gov/21654132/
  9. Weeranut C, Leena C, Kanokvalai K, Jongjarearnprasert K, Dhana N. Cutaneous adverse reactions to sulfonamide antibiotics. Asian Pac J Allergy Immunol. 2011; 29: 284-289. PubMed: https://pubmed.ncbi.nlm.nih.gov/22053600/
  10. Krebs A, Boillat-Armagni C, Saurat JH. Réactions cutanées aux médicaments. In: Dermatoses des états d'hypersensibilité 2ème ed. Paris: Masson. 1990: 911.
  11. Ramorasata JA, Raveloson NE, Tohaina D. Caractéristiques épidémio-cliniques des nécrolyses épidermiques toxiques dans le service de réanimation de l’Hôpital de Soavinandriana Antananarivo. Rev Anest Réa Urg. 2009; 1: 21-25.
  12. Khaled A, Kharfi M, Ben Hamida M, El Fekih N, El Aidli S, et al. Cutaneous adverse drug reactions in children. A series of 90 cases. Tunis Med. 2012; 90: 45-50. PubMed: https://pubmed.ncbi.nlm.nih.gov/22311448/
  13. Aguèmon AR, Houngbé F, Yaméogo TM. Nécrolyse épidermique toxique, revue des cas Observés dans le service de réanimation du centre national hospitalier et universitaire de Cotonou. Ann Fr Anesth Réanim. 2006; 25: 505-509.
  14. Bahadoran P, Castanet J, Lacour LP, Perrin C, Del Giudice P, et al. Pseudo-dermatomyositis induced by long-term hydroxyurea therapy: report of two cases. Br J Dermatol. 1996; 134: 1161-1163. PubMed: https://pubmed.ncbi.nlm.nih.gov/8763456/

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More