Volume 12 Issue 4
Investigating the Underlying Mechanism and Risk Factors Associated with Adverse Drug Reactions Manifesting on the Skin: A Comprehensive Approach to Improving Patient Safety
1Dr kanwal sultana, 2Dr Muhammad Kashif, 3Dr. Syed Zeeshan Safdar, 4Dr Mahnoor Chaudhry, 5Dr Muhammad Burhan Javid, 6Dr Najam Asif
1Skin specialist, Skin clinic at Chakwal
2Medical Officer, Indus hospital & health network
3Medical officer, Indus hospital & health network
4Rai medical college teaching hospital Sargodha
5Rai medical college teaching hospital Sargodha
6Rai medical college teaching hospital Sargodha
ABSTRACT
Background: Adverse drug reactions (ADRs) affecting the skin can range from mild rashes to severe life-threatening conditions such as Stevens-Johnson syndrome. Identifying the underlying mechanisms and risk factors associated with these reactions is crucial for improving patient safety and optimizing drug therapy.
Aim: This study aimed to investigate the mechanisms and risk factors contributing to cutaneous ADRs to enhance early detection and prevention strategies.
Methods: A prospective observational study was conducted at Services Hospital, Lahore, from October 2023 to September 2024. A total of 50 patients who developed skin-related ADRs were included. Clinical assessments, detailed medication histories, and laboratory investigations were performed to determine potential drug culprits and underlying mechanisms. The severity of reactions was classified using the Naranjo Adverse Drug Reaction Probability Scale.
Results: Among the 50 participants, 60% were female and 40% were male, with a mean age of 42.3 ± 11.7 years. The most frequently implicated drug classes were antibiotics (40%), nonsteroidal anti-inflammatory drugs (NSAIDs) (28%), and antiepileptics (18%). The most common manifestations included maculopapular rashes (46%), urticaria (22%), and fixed drug eruptions (18%), while severe reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis accounted for 8%. Risk factors identified included a history of previous drug reactions (34%), polypharmacy (48%), and underlying autoimmune disorders (20%). The majority of cases (72%) were classified as probable ADRs according to the Naranjo Scale, while 18% were deemed definite.
Conclusion: Skin-related ADRs were predominantly associated with antibiotics, NSAIDs, and antiepileptic drugs. Polypharmacy and a history of previous drug reactions significantly increased the risk. Early identification of high-risk individuals and judicious drug prescribing are essential for preventing severe outcomes. These findings underscore the importance of pharmacovigilance and patient education to improve medication safety.
Keywords: Adverse drug reactions, cutaneous toxicity, pharmacovigilance, risk factors, drug safety, Stevens-Johnson syndrome.