Retrospective Analysis Of 201 Cases Of Drug-induced Dermatiti

Purpose:To explore the types,clinical manifestations,TCM symptom types and medications of patients with drug eruptions,explore the correlation between sensitizing drug types and clinical manifestations and TCM symptom types,and the medication rules of internal and external treatment methods of Chinese and Western medicine,so as to provide reference for clinical differentiation and treatment.Material and method:This study carefully and meticulously recorded the clinical data of patients hospitalized and diagnosed with drug-induced dermatitis from January 2010 to December 2022 to our ward,including general information（name,gender,age,length of hospitalization,etc.）,specific sensitizing drugs,rash site,allergy history,manifestations and signs of drug-induced dermatitis,laboratory tests,TCM differential treatment,Western medicine treatment,etc.,so as to analyze the clinically related factors of drug-induced dermatitis and the characteristic treatment methods of TCM combined diagnosis and treatment.Results:1.General information:the number of female patients is 131,the number of male patients is70,the male sex ratio is about 1:1.87,and the average age of patients is 50.42 years.2.Sensitizing drugs:sensitizing drugs were mainly concentrated in antibacterial drugs（116cases）,traditional Chinese medicine,Chinese proprietary medicine（54 cases）,antipyretic,analgesic,anti-inflammatory and anti-rheumatic drugs（34 cases）,and digestive system drugs（17 cases）.3.Laboratory examination:the proportion of ALT outliers in SJS is the highest 37.50%.The proportion of abnormalities in LDH and HBDH was high,and the highest proportion of abnormalities in LDH and HBDH in urticarial drug eruptions was 48.48%and 39.39%.The incidence of calcium ions in erythematous multiforme eruptions was 23.08%,in purpuric eruptions 14.29%,and in severe erythematous multiforme eruptions（SJS）in 12.50%.The ranking of C-reactive protein abnormalities was SJS（75.00%）,greater than urticarial drug eruption（66.67%）,greater than purpuric drug eruption（57.14%）,greater than erythematous multiforme drug eruption（53.85%）,and greater than eruption-type drug eruption（38.64%）.The total Ig A anomaly rate was 61.6%,the total Ig G anomaly rate was 63.6%,and the total Ig M anomaly rate was 53.2%.SJS had the highest proportion of ALT outliers at 37.50%.The proportion of Ca²⁺outliers in SJS was 12.50%.4.Traditional Chinese medicine treatment:The percentage of Chinese medicine treatment of Chinese medicine external medicine（51.74%）is greater than that of Chinese medicine injection（21.39%）,greater than that of Chinese medicine decoction（13.93%）,and greater than that of Chinese proprietary medicine（12.94%）.Traditional Chinese medicine physiotherapy can be divided into ear point bean pressing,eartip bloodletting and acupoint application,among which the utilization rate of eartip bloodletting（79/201,39.30%）is greater than that of ear point bean pressing（56/201,27.86%）than that of acupoint application（17/201,8.46%）.5.Western medicine treatment:mainly use glucocorticoids and antihistamines to treat drug-induced dermatitis,the lowest drug-induced dermatitis type with the lowest rate of glucocorticoids is purpura drug eruption（85.7%）,and the highest type of drug-induced dermatitis is eczema-like drug eruption,severe erythematous multiforme drug eruption（100%）.Antihistamines can be divided into 3 cases（3/201,1.5%）without antihistamines,44（44/201,21.9%）with only one antihistamine,148（148/201,73.6%）with 2 antihistamines,8（8/201,4.0%）with 3 antihistamines,and 1（1/201,0.5%）with 4 antihistamines.Among the antihistamines used by patients,ebastine had the highest proportion（50.75%）,followed by chlorpheniramine maleate（42.79%）,and levocetirizine hydrochloride（31.84%）.Conclusion:1.In this study,the incidence of female dermatitis patients is significantly higher than that of men.It is more likely to occur in middle-aged and elderly people,with an average age of50.42 years.2.The patient’s sensitization drugs were mainly concentrated antibacterial drugs（57.71%,including cephalosporins,penicillins,quinolones,etc.）,traditional Chinese medicine,Chinese proprietary medicine（26.87%）,antipyretic,analgesic,anti-inflammatory and anti-rheumatic drugs（16.92%）,digestive system drugs（8.46%）.No specific link has been found between drug classification and drug-induced dermatitis classification.There was no obvious correlation between drug types and TCM differentiation.3.Drug-induced dermatitis often brings abnormalities in myocardial enzyme profile（LDH,HBDH）,C-reactive protein,and immune function,among which heavy drug eruptions are often accompanied by abnormalities in liver function and calcium ions.4.Traditional Chinese medicine treatment of drug-induced dermatitis mostly uses external treatment and traditional Chinese medicine physiotherapy to adjuvant treatment,and oral and intravenous drugs are less;Western medicine treatment is mostly glucocorticoids combined with a variety of desensitizing drugs,while using vitamin C,calcium,and immunomodulators for joint treatment.