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Epidemiology of drug-induced dermatoses: Prevalence, risk factors, and clinical outcomes

Pamela-Martina Hristova-Stoeva, Filka Georgieva

Abstract

Introduction

Drug-induced dermatoses are adverse skin reactions triggered by medications, ranging from mild rashes to severe conditions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Understanding their prevalence, risk factors, and clinical presentations is essential for effective prevention and management. This study investigates the epidemiology, types, and risk factors associated with drug-induced dermatoses, providing insights for healthcare providers.

Materials and Methods

A comprehensive review of 125 studies (2000–2024) was conducted using databases such as MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. Data from literature reviews, observational studies, clinical trials, and case reports were analyzed to determine the prevalence, implicated drugs, and demographic or clinical factors influencing these reactions.

Results

Drug-induced dermatoses include a spectrum of reactions from mild to life-threatening. Commonly implicated drugs are antibiotics, NSAIDs, and antiepileptics, with prevalence rates of 0.5% to 5% among high-risk drug users. Severe reactions include SJS/TEN, drug reactions with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). Significant risk factors include genetic predispositions (e.g., HLA-B*1502 for carbamazepine), age extremes, pre-existing conditions such as autoimmune diseases or HIV, and factors related to the type, dose, and duration of drug exposure.

Conclusion

Healthcare providers should identify high-risk drugs and implement measures such as genetic screening to minimize adverse reactions. Improving diagnostics, clinicians’education, and antibiotic stewardship is vital. Further research into genetic biomarkers and personalized medicine could reduce the clinical and societal impact of these reactions, enhancing patient care and outcomes.


Keywords

drug-induced dermatoses, epidemiology, adverse drug reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, antibiotics

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DOI: http://dx.doi.org/10.14748/ssm.v55i2.9582
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About The Authors

Pamela-Martina Hristova-Stoeva
Medical University of Varna
Bulgaria

Department of Infectious diseases, Parasitology and Dermatovenereology, Faculty of Medicine

Filka Georgieva
Medical University of Varna
Bulgaria

Department of Infectious diseases, Parasitology and Dermatovenereology, Faculty of Medicine

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