Prevalence and clinical manifestations of drug eruptions in hospitalized patients: a ten-year cross-sectional observational study in a tertiary care hospital in Argentina

Abstract

Introduction: adverse drug reactions (ADRs) with cutaneous, mucosal, and/or adnexal involvement, known as drug-induced dermatoses (pharmacodermias), are among the most frequent manifestations of drug-related adverse effects. It is estimated that 10–30% of ADRs affect the skin and that 2–10% of hospitalized patients develop drug-induced cutaneous manifestation.

Objectives: to determine the prevalence of drug eruptions among hospitalized patients at Hospital Universitario Austral during the period from January 1, 2014, to December 31, 2024, and to describe their main clinical, therapeutic, and evolutionary characteristics.

Materials and methods: cross-sectional, descriptive study. All patients ≥18 years old hospitalized with a clinical diagnosis of drug-induced dermatosis confirmed by the Dermatology Department were included.

Results: a total of 110 patients were analyzed, with a prevalence of 0.073% of drug-induced skin reactions. The mean age was 55 years, with a male predominance. Maculopapular rash was the most frequent presentation (69.1%), followed by drug reaction with eosinophilia and systemic symptoms (DRESS) (14.5%) and acute generalized exanthematous pustulosis (5.5%). The latency period was 5-8 days in most cases and 21 days in Stevens-Johnson syndrome. A causative drug was identified in 60.9% of cases, mainly beta-lactam and glycopeptide antibiotics; in 39.1%, a single agent could not be determined. Complete recovery occurred in 97.3% of patients.

Conclusions: the prevalence was low and outcomes were generally favorable. Antibiotics were the most frequently implicated drugs; however, in a considerable proportion of cases, the causative agent could not be identified. Early diagnosis may reduce drug-related morbidity and mortality.