약진의 임상적 고찰 = Clinical review and skin test of patients with drug eruption

다국어 초록 (Multilingual Abstract)

Background: Drug eruption is a relatively common disorder and may cause significant problems. Nevertheless, there have only been a few clinical studies of drug eruption in Korea. Objective : The purpose of this study was to define the clinical features and causative drugs of drug eruption, and to evaluate the diagnostic value of skin test and provocation test. Methods : We reviewed clinical data and laboratory results from 161 patients with drug eruptions. Furthermore, we performed skin test and provocation test on 12 and 8 patients, respectively. Results : The common clinical types were fixed drug eruption (31%), exanthematous eruption (29.8%), urticaria (9%), and EM/Stevens-Johnson syndrome/TEN (5%). The mean latent period was 14.1 days, varying from 3.6 days for fixed drug eruption to 175 days for lichenoid eruption. The major causative drugs were antibiotics (23.6%), common cold remedies (20.5%), nonsteroidal antiinflammatory drugs (10.6%), and herb medication and health foods (5.6%). The evaluation of the frequencies of drug eruption revealed 43.5% of the patients with one attack, and 32% of the patients be more than two attacks. The common underlying diseases were upper respiratory infection (26.7%), postoperative prophylactic medications (15.0%), infections (14.3%), and gastrointestinal troubles (6.2%). The skin test was positive in 5 of 12 patients (41.7%), and provocation test was positive in 2 of 8 patients (25%). Among the clinical types of drug eruption, EM/Stevens-Johnson syndrome/TEN had the earliest onset (25 years) and pustular type showed the latest onset (49.1 years). Females were more commonly affected than males in exanthematous type (2.7:1) and EM/Stevens-Johnson syndrome/ TEN (3:1). Comparing frequencies of drug eruption, fixed drug eruption and urticarial type showed higher frequencies than other types. Conclusion - Although there were some limitations in estimating the values of skin test and provocation test in this study, they still remain the most reliable methods for evaluating drug eruption.