Dermoscopic Aspects of Cutaneous Adverse Drug Reactions
Background: Little is known about the dermoscopic evaluation of cutaneous adverse drug reactions (CADRs). Objectives: To evaluate the dermoscopic patterns of CADRs and identify those associated with severe cutaneous adverse reactions to drugs (SCARDs). Patients and Methods: Patients included...
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Mattioli1885
2021
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oai:doaj.org-article:b718b94ae5894db3853dc5161df9d3442021-11-17T08:28:19ZDermoscopic Aspects of Cutaneous Adverse Drug Reactions10.5826/dpc.1101a1362160-9381https://doaj.org/article/b718b94ae5894db3853dc5161df9d3442021-01-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/1296https://doaj.org/toc/2160-9381 Background: Little is known about the dermoscopic evaluation of cutaneous adverse drug reactions (CADRs). Objectives: To evaluate the dermoscopic patterns of CADRs and identify those associated with severe cutaneous adverse reactions to drugs (SCARDs). Patients and Methods: Patients included in this study from May 2015 to April 2016 had presented with CADRs. CADR presentation and classification were based on standard criteria. SCARDs included Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), overlap SJS/TEN, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). The dermoscopic features of CADRs were described and compared according to the severity of the reactions. Results: Sixty-nine patients were included. Sixteen patients (23.2%) presented SCARDs. The main dermoscopic findings in SJS, overlap SJS/TEN and TEN were black dots or necrotic areas (100%). Erosion [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1 (100%)], necrotic borders [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1, (100%)] and epidermal detachment [respectively, 5/6 (83.3%); 2/3 (66.7%) and 1/1 (100%)] were also common among these reactions. Erythema and purpuric dots were the main dermoscopic findings [respectively, 5/6 (83.3%) and 4/6 (66.7%)] in DRESS. In non-severe reactions, the most prevalent structures were erythema and purpura in exanthema [respectively, 31/33 (93.9%) and 24/33 (72.7%)] and erythema and vascular structures in urticarial reactions [respectively, 6/6 (100%) and 3/6 (50%)]. Black dots or necrotic areas, epidermal detachment, necrotic borders and erosion were highly associated with SCARDs (P < 0.001). Conclusions: Dermoscopy improves clinical recognition of SCARDs. Gabriela RossiAndré da Silva CartellRenato Marchiori BakosMattioli1885articlecutaneous adverse drug reactionsdrug eruptionsdermoscopic patternsdermoscopyDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 11, Iss 1 (2021) |
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DOAJ |
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cutaneous adverse drug reactions drug eruptions dermoscopic patterns dermoscopy Dermatology RL1-803 |
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cutaneous adverse drug reactions drug eruptions dermoscopic patterns dermoscopy Dermatology RL1-803 Gabriela Rossi André da Silva Cartell Renato Marchiori Bakos Dermoscopic Aspects of Cutaneous Adverse Drug Reactions |
description |
Background: Little is known about the dermoscopic evaluation of cutaneous adverse drug reactions (CADRs).
Objectives: To evaluate the dermoscopic patterns of CADRs and identify those associated with severe cutaneous adverse reactions to drugs (SCARDs).
Patients and Methods: Patients included in this study from May 2015 to April 2016 had presented with CADRs. CADR presentation and classification were based on standard criteria. SCARDs included Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), overlap SJS/TEN, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). The dermoscopic features of CADRs were described and compared according to the severity of the reactions.
Results: Sixty-nine patients were included. Sixteen patients (23.2%) presented SCARDs. The main dermoscopic findings in SJS, overlap SJS/TEN and TEN were black dots or necrotic areas (100%). Erosion [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1 (100%)], necrotic borders [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1, (100%)] and epidermal detachment [respectively, 5/6 (83.3%); 2/3 (66.7%) and 1/1 (100%)] were also common among these reactions. Erythema and purpuric dots were the main dermoscopic findings [respectively, 5/6 (83.3%) and 4/6 (66.7%)] in DRESS. In non-severe reactions, the most prevalent structures were erythema and purpura in exanthema [respectively, 31/33 (93.9%) and 24/33 (72.7%)] and erythema and vascular structures in urticarial reactions [respectively, 6/6 (100%) and 3/6 (50%)]. Black dots or necrotic areas, epidermal detachment, necrotic borders and erosion were highly associated with SCARDs (P < 0.001).
Conclusions: Dermoscopy improves clinical recognition of SCARDs.
|
format |
article |
author |
Gabriela Rossi André da Silva Cartell Renato Marchiori Bakos |
author_facet |
Gabriela Rossi André da Silva Cartell Renato Marchiori Bakos |
author_sort |
Gabriela Rossi |
title |
Dermoscopic Aspects of Cutaneous Adverse Drug Reactions |
title_short |
Dermoscopic Aspects of Cutaneous Adverse Drug Reactions |
title_full |
Dermoscopic Aspects of Cutaneous Adverse Drug Reactions |
title_fullStr |
Dermoscopic Aspects of Cutaneous Adverse Drug Reactions |
title_full_unstemmed |
Dermoscopic Aspects of Cutaneous Adverse Drug Reactions |
title_sort |
dermoscopic aspects of cutaneous adverse drug reactions |
publisher |
Mattioli1885 |
publishDate |
2021 |
url |
https://doaj.org/article/b718b94ae5894db3853dc5161df9d344 |
work_keys_str_mv |
AT gabrielarossi dermoscopicaspectsofcutaneousadversedrugreactions AT andredasilvacartell dermoscopicaspectsofcutaneousadversedrugreactions AT renatomarchioribakos dermoscopicaspectsofcutaneousadversedrugreactions |
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