Phenotypes of Severe Cutaneous Adverse Reactions Caused by Nonsteroidal Anti-inflammatory Drugs
- 주제(키워드) Anti-Inflammatory Agents , Non-Steroidal , Drug Hypersensitivity , Stevens-Johnson Syndrome
- 주제(기타) Allergy
- 주제(기타) Immunology
- 설명문(일반) [Lee, Suh-Young; Kang, Hye-Ryun] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Lee, Suh-Young; Kang, Hye-Ryun] Seoul Natl Univ, Med Res Ctr, Inst Allergy & Clin Immunol, Seoul, South Korea; [Nam, Young Hee] Dong A Univ, Coll Med, Dept Internal Med, Busan, South Korea; [Koh, Young-Il] Chonnam Natl Univ, Med Sch, Dept Internal Med, Gwangju, South Korea; [Kim, Sae Hoon] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Seongnam, South Korea; [Kim, Sujeong] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea; [Kim, Min-Hye] Ewha Womans Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Lee, Jun-Gyu] Dongguk Univ, Ilsan Hosp, Dept Internal Med, Goyang, South Korea; [Park, Jung-Won] Yonsei Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Park, Hye-Kyung] Pusan Natl Univ, Coll Med, Dept Internal Med, Busan, South Korea; [La, Hyen O.] Catholic Univ Korea, Coll Med, Dept Pharmacol, Seoul, South Korea; [Kim, Mi-Yeong] Inje Univ, Busan Paik Hosp, Dept Internal Med, Busan, South Korea; [Park, Seong Ju] Chonbuk Natl Univ, Med Sch, Dept Internal Med, Jeonju, South Korea; [Kwon, Yong-Eun] Chosun Univ Hosp, Dept Internal Med, Gwangju, South Korea; [Jung, Jae-Woo] Chung Ang Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Sang Hyon] Keimyung Univ, Dongsan Med Ctr, Dept Internal Med, Daegu, South Korea; [Kim, Cheol-Woo] Inha Univ, Sch Med, Dept Internal Med, Incheon, South Korea; [Yang, Min-Seok] SMG SNU Boramae Med Ctr, Dept Internal Med, Seoul, South Korea; [Kang, Min-Gyu] Chungbuk Natl Univ Hosp, Dept Internal Med, Cheongju, South Korea; [Lee, Jin Yong] Kangdong Sacred Heart Hosp, Dept Dermatol, Seoul, South Korea; [Kim, Joo-Hee] Hallym Univ, Sacred Heart Hosp, Dept Internal Med, Anyang, South Korea; [Kim, Sang-Heon] Hanyang Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Hur, Gyu Young] Korea Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Jee, Young-Koo] Dankook Univ, Coll Med, Dept Internal Med, Cheonan, South Korea; [Jin, Hyun Jung] Yeungnam Univ, Coll Med, Dept Internal Med, Daegu, South Korea; [Park, Chan Sun] Inje Univ, Haeundae Paik Hosp, Dept Internal Med, Busan, South Korea; [Jeong, Yi Yeong] Gyeongsang Natl Univ, Sch Med, Dept Internal Med, Jinju, South Korea; [Ye, Young-Min] Ajou Univ, Sch Med, Dept Allergy & Clin Immunol, 164 Worldcup Ro, Suwon 16499, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, Green Submitted, hybrid
- 발행기관 KOREAN ACAD ASTHMA ALLERGY & CLINICAL IMMUNOLOGY
- 발행년도 2019
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000171892
- 본문언어 영어
- Published As https://dx.doi.org/10.4168/aair.2019.11.2.212
- PubMed https://pubmed.ncbi.nlm.nih.gov/30661313
초록/요약
Purpose: Nonsteroidal anti-inflammatory drugs (NSAIDs) are common cause of severe cutaneous adverse reactions (SCARs). The present study aimed to investigate the characteristics of SCARs induced by NSAIDs in the Korean SCAR registry. Methods: A retrospective survey of NSAID-induced SCARs recorded between 2010 and 2015 at 27 university hospitals in Korea was conducted. Clinical phenotypes of SCARs were classified into Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), SJS-TEN overlap syndrome and drug reaction with eosinophilia and systemic symptoms (DRESS). Causative NSAIDs were classified into 7 groups according to their chemical properties: acetaminophen, and propionic, acetic, salicylic, fenamic and enolic acids. Results: A total of 170 SCARs, consisting of 85 SJS, 32 TEN, 17 SJS-TEN overlap syndrome and 36 DRESS reactions, were induced by NSAIDs: propionic acids (n=68), acetaminophen (n=38), acetic acids (n=23), salicylic acids (n=16), coxibs (n=8), fenamic acids (n=7), enolic acids (n=5) and unclassified (n=5). Acetic acids (22%) and coxibs (14%) accounted for higher portions of DRESS than other SCARs. The phenotypes of SCARs induced by both propionic and salicylic acids were similar (SJS, TEN and DRESS, in order). Acetaminophen was primarily associated with SJS (27%) and was less involved in TEN (10%). DRESS occurred more readily among subjects experiencing coxib-induced SCARs than other NSAID-induced SCARs (62.5% vs. 19.7%, P = 0.013). The mean time to symptom onset was longer in DRESS than in SJS or TEN (19.1 +/- 4.1 vs. 6.8 +/- 1.5 vs. 12.1 +/- 3.8 days). SCARs caused by propionic salicylic acids showed longer latency, whereas acetaminophen- and acetic acid-induced SCARs appeared within shorter intervals. Conclusions: The present study indicates that the phenotypes of SCARs may differ according to the chemical classifications of NSAIDs. To establish the mechanisms and incidences of NSAID-induced SCARs, further prospective studies are needed.
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