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학술저널
저자정보
이서영 (서울대학교병원) 남영희 (동아대학교) 고영일 (전남대학교) 김세훈 (서울대학교병원) 김수정 (경북대학교) 강혜련 (서울대학교) 김민혜 (이화여자대학교) 이준규 (동국대학교) 박정원 (연세대학교) 박혜경 (부산대학교) 나현오 (가톨릭대학교) 김미영 (인제대학교부속부산백병원) 박성주 (전북대학교) 권용은 (조선대학교) 정재우 (중앙대학교) 김상현 (계명대학교) 김철우 (인하대학교) 양민석 (서울특별시보라매병원) 강민규 (충북대학교병원) 이진용 (서울특별시보라매병원) 김주희 (한림대학교) 김상헌 (한양대학교) 허규영 (고려대학교) 지영구 (단국대학교) 진현정 (영남대학교) 박찬선 (인제대학교 해운대백병원) 정이영 (경상대학교) 예영민 (아주대학교)
저널정보
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.11 No.2
발행연도
2019.1
수록면
212 - 221 (10page)

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Purpose: Nonsteroidal anti-inflammatory drugs (NSAIDs) are common cause of severe cutaneous adverse reactions (SCARs). The present study aimed to investigate the characteristics of SCARs induced by NSAIDs in the Korean SCAR registry. Methods: A retrospective survey of NSAID-induced SCARs recorded between 2010 and 2015 at 27 university hospitals in Korea was conducted. Clinical phenotypes of SCARs were classified into Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), SJS-TEN overlap syndrome and drug reaction with eosinophilia and systemic symptoms (DRESS). Causative NSAIDs were classified into 7 groups according to their chemical properties: acetaminophen, and propionic, acetic, salicylic, fenamic and enolic acids. Results: A total of 170 SCARs, consisting of 85 SJS, 32 TEN, 17 SJS-TEN overlap syndrome and 36 DRESS reactions, were induced by NSAIDs: propionic acids (n=68), acetaminophen (n=38), acetic acids (n=23), salicylic acids (n=16), coxibs (n=8), fenamic acids (n=7), enolic acids (n=5) and unclassified (n=5). Acetic acids (22%) and coxibs (14%) accounted for higher portions of DRESS than other SCARs. The phenotypes of SCARs induced by both propionic and salicylic acids were similar (SJS, TEN and DRESS, in order). Acetaminophen was primarily associated with SJS (27%) and was less involved in TEN (10%). DRESS occurred more readily among subjects experiencing coxib-induced SCARs than other NSAID-induced SCARs (62.5% vs. 19.7%, P = 0.013). The mean time to symptom onset was longer in DRESS than in SJS or TEN (19.1 ± 4.1 vs. 6.8 ±1.5 vs. 12.1 ± 3.8 days). SCARs caused by propionic salicylic acids showed longer latency, whereas acetaminophen- and acetic acid-induced SCARs appeared within shorter intervals. Conclusions: The present study indicates that the phenotypes of SCARs may differ according to the chemical classifications of NSAIDs. To establish the mechanisms and incidences of NSAID-induced SCARs, further prospective studies are needed.

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