Severe cutaneous adverse reactions (SCARs) to drugs in Latin America: RACGRAD study

Severe cutaneous adverse reactions to drugs (SCARs), have a high morbidity, mortality and present sequelae. Objective: To characterize patients with SCARs in eight health care institutions in Latin America. Cross-sectional, descriptive, multicenter, Latin American study of patients diagnosed with SCARs, between January 2009 and December 2018. The analysis was made from a database in BD Clinic. Seventy cases were reported. Forty-two (60%) were women. The average age was 38.7 years. Forty-two (60%) had DRESS-DIHS, 12 (17.1%) TEN, 5 (7.1%) SJS, 6 (8.5%) AGEP, 4 (5.7%) other, not classified SCARs, and 1 (1.4%) overlapping TEN/SJS. The main causative drugs were aromatic anticonvulsants in 31 cases (44.3%), beta lactam antibiotics in 11 cases (15.7%) and non-beta lactam antibiotics in 6 cases (8.6%). In all of cases, the suspected drug was withdrawn at the first sign of a SCAR. Sixty-six patients (94.2%) received anti-inflammatory treatment, mostly systemic corticosteroids. Complications occurred in 53 cases (75.7%) and death in three patients (4.3%). Thirteen patients (18.6%) had some type of sequelae. This is the first multicenter report on SCARs in Latin America. DRESS-DIHS was the most frequently reported clinical entity and anticonvulsants were the main triggers. Most of patients received systemic corticosteroids. Complications were frequent and three patients died.