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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949

Abstract

DI MARTINO ORTIZ, B  and  HOSPITAL DE CLINICAS. FACULTAD DE CIENCIAS MEDICAS. UNIVERSIDAD NACIONAL DE ASUNCION. Cátedra de Dermatología. Histopathology of drug eruptions at the Department of Dermatology, Hospital de Clinicas, FCM-UNA. An. Fac. Cienc. Méd. (Asunción) [online]. 2014, vol.47, n.1, pp.19-32. ISSN 1816-8949.

ABSTRACT Introduction: Toxicodermias comprise all adverse drug reactions (ADRs) that are expressed primarily at the skin or mucous membrane level due to a drug, regardless of the manner of administration thereof. Objectives: To determine the Dermatopathological, clinical and epidemiological characteristics of toxicodermias in the Department of Dermatology, Hospital de Clinicas, FCM-UNA. Material and Methods: Descriptive, observational, retrospective, cross-sectional study with an analytical component of patients of any age or gender who were treated at the Department of Dermatology, Hospital de Clinicas, FCM-UNA of both sexes and of any age with confirmed farmacodermia diagnosis during January 2008 to December 2012. Results: The frequency of toxicodermias is 1,6% with a slight predominance in female patients (53%) and with a peak incidence in the fourth decade of life (15%). The most frequent reason for consultation was erythema (52%) macula (43%), finding that most of the injuries occurred within 7 days of drug administration (36%). The most commonly involved drugs were NSAIDs, anticonvulsants and antibiotics. 80% of patients showed lichenoid eruptions. The overall percentage of agreement is a p0=0,918369 and the kappa coefficient is=0,836738. Conclusions: As in most other dermatological diseases, the diagnosis of cutaneous adverse drug reactions is based on clinico-pathological correlation. Nevertheless, there are some histopathological clues that can suggest this diagnosis such as the presence of tisular eosinophilia and/or dyskeratosis and the combination of unusual and apparently incongruent histopathological patterns. Identification of histopathological patterns and anatomoclinical correlation are indispensable for the differential with other inflammatory dermatoses, allowing for an early and precise diagnosis and a reduction of treatment and hospitalization costs. Key Words: toxicodermias, adverse drug reactions, lichenoid drug eruptions.

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