CLINICAL-PATTERN OF CUTANEOUS DRUG ERUPTION AMONG CHILDREN AND ADOLESCENTS IN NORTH-INDIA

Various types of cutaneous drug eruptions and the incriminating drugs were analyzed in 50 children and adolescents up to 18 years of age (34 or 65% boys, 16 or 32% girls). Thirteen (26%) patients had a maculopa pular rash, 11 (22%) a fixed drug eruption (FDE), 10 erythema multifor me (EM), 6 (12%) toxic epidermal necrolysis (TEN), 5 (10%) Stevens-Joh nson syndrome (SJS), 3 (6%) urticaria, and 2 (4%) erythroderma. The in cubation period for maculopapular rashes, SJS and TEN due to commonly used antibiotics and sulfonamides was short, a few hours to two to thr ee days, reflecting reexposure, and for drugs used sparingly such as a ntiepileptics and antituberculosis agents, was approximately one week or more, suggesting a first exposure. Antibiotics were responsible for cutaneous eruptions in 27 patients, followed by antiepileptics in 17, analgin in 4, and metronidazole and albendazole in 1 each. Cotrimoxaz ole, a combination of sulfamethoxazole and trimethoprim, was the most common antibacterial responsible for eruptions (11 patients), followed by penicillin and its semisynthetic derivatives (8 patients), sulfona mide alone (3 patients), and other antibiotics (4 patients). Antiepile ptics were the most frequently incriminated drugs in EM, TEN, and SJS. The role of systemic corticosteroids in the management of SJS and TEN is controversial. We administered prednisolone or an equivalent corti costeroid 2 mg/kg/day for 7 to 14 days. With this dosage the mortality rate in the combined patients with TEN and SJS was 18.2%. Our limited experience suggests that these drugs might still have a role in the m anagement of SJS and TEN in children and adolescents.