Fixed Drug Eruption in Children: a 24-Year, Single-center,  Retrospective Cohort Study from Turkey

Babuna Kobaner Goncagül; Özkaya Esen

doi:https://dx.doi.org/10.26650/jchild.2021.925276

Research Article

DOI :10.26650/jchild.2021.925276 IUP :10.26650/jchild.2021.925276 Full Text (PDF)

Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey

Objective: Fixed drug eruption (FDE), although a common type of drug eruption affecting all ages, has rarely been reported in children. This study aimed to investigate the characteristics of pediatric patients with FDE diagnosed in a tertiary referral center from Turkey. Material and Methods: A single-center, retrospective cohort study based on the analysis of data of patients with an established diagnosis of FDE between 1996-2019, using standard forms prepared for the purpose of precise clinical documentation. Results: The overall prevalence of pediatric FDE was 10.4% (n=22/212). Cotrimoxazole was the leading sensitizer before 2003, whereas nonsteroidal anti-inflammatory drugs (mainly naproxen) predominated thereafter. Phenobarbital in suppositories for fever was another important cause of pediatric FDE in younger children. The most frequently involved site was the trunk (68.2%), followed by the lips (54.5%), and extremities (45.5%). Cotrimoxazole was the leading causative agent in every location, except for phenobarbital in perioral area. Oral mucosa was involved in 36.4% of the patients, mainly with multiple lesions involving inner lip mucosa (75.0%). Its major morphological form was bullous/erosive (50.0%). Genital mucosa was less commonly (31.8%) involved. Among 9 children with cotrimoxazole-induced FDE, 5 (55.6%) were positive for complete haplotype (HLA-A30 B13 Cw6) or separate antigens (HLA-A30 or HLA-Cw6), supporting a possible link between cotrimoxazole-induced FDE and HLA-A30. Conclusion: This study showed that FDE is a common type of drug eruption in the pediatric population. Clinical findings, drug-specific site involvement, and most common inducers of FDE in children seem to be largely similar to those in adults.

Keywords: Children, cotrimoxazole, fixed drug eruption, non-steroidal anti-inflammatory drugs, naproxen, pediatric

DOI :10.26650/jchild.2021.925276 IUP :10.26650/jchild.2021.925276 Full Text (PDF)

Çocuklarda Görülen Fiks İlaç Erüpsiyonu: Türkiye’den 24-Yıllık, Tek Merkezli, Retrospektif Bir Çalışma

Goncagül Babuna Kobaner, Esen Özkaya

Amaç: Fiks ilaç erüpsiyonu (FİE), sık görülen ve her yaşı etkileyebilen bir ilaç döküntüsü olmasına rağmen çocuklarda nadiren bildirilmiştir. Çalışmamızda, Türkiye’de üçüncü basamak bir referans merkezde FİE tanısı konulmuş olan pediatrik hastaların karakteristik özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu tek-merkezli, retrospektif kohort çalışması, kliniğimizde 1996-2019 yılları arasında FİE tanısı konularak takip ve tedavi edilen çocuk hastaların, standart olarak hazırlanmış hasta takip formlarındaki verilerinin analiz edilmesiyle gerçekleştirilmiştir. Bulgular: Çalışmamızda pediatrik FİE’nin genel prevalansı %10,4 (n=22/212) olarak bulundu. Çocuklarda FİE’nin en sık nedeni 2003 yılından önce kotrimoksazol iken daha sonraki yıllarda non-steroidal antienflamatuvar ilaçlar (özellikle naproksen) ön plandaydı. Ateş düşürücü supozituvarlar içinde bulunan fenobarbital de özellikle küçük çocuklarda FİE’nin bir diğer önemli nedeniydi. Çocuklarda en çok tutulan alanlar sırasıyla gövde (%68,2), dudaklar (%54,5) ve ekstremiteler (%45,5) olarak bulundu. Hemen her bölgede FİE’nin en sık nedeni kotrimoksazol iken, perioral bölgede fenobarbitaldi. Çocukların %36,4’ünde oral mukoza tutulumu görüldü. Oral mukoza lezyonları genellikle multiple olup iç dudak mukozasını tutmaktaydı (%75,0) ve en sık görülen morfolojik formu büllöz/erozif (50,0%) idi. Çocuklarda genital mukoza tutulumuna daha nadir (%31,8) rastlandı. Kotrimoksazole-bağlı FİE’si olan ve HLA tiplendirilmesi yapılan 9 çocuktan 5’inde (%55,6) komplet haplotip (HLA-A30 B13 Cw6) veya tek başına antijen (HLA-A30 veya HLA-Cw6) pozitiflikleri saptandı. Bu bulgu, kotrimoksazole bağlı FİE ile HLA-A30 arasında potansiyel bir ilişki olduğunu destekler nitelikteydi. Sonuç: Çalışmamız, FİE’nin pediatrik yaş grubunda sık görülen bir ilaç erüpsiyonu olduğunu ortaya koymuştur. Ayrıca, çocuklarda görülen FİE’nin, klinik bulgular, ilaca-spesifik bölge tutulumu ve en sık neden olan ilaçlar açısından erişkinlerde görülen FİE’ye büyük ölçüde benzerlik gösterdiği saptanmıştır

Keywords: Çocuklar, fiks ilaç erüpsiyonu, kotrimoksazol, nonsteroidal antienflamatuvar ilaçlar, naproksen, pediatrik

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APA

Babuna Kobaner, G., & Özkaya, E. (2021). Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey. Journal of Child, 21(2), 142-148. https://doi.org/10.26650/jchild.2021.925276

AMA

Babuna Kobaner G, Özkaya E. Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey. Journal of Child. 2021;21(2):142-148. https://doi.org/10.26650/jchild.2021.925276

ABNT

Babuna Kobaner, G.; Özkaya, E. Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey. Journal of Child, [Publisher Location], v. 21, n. 2, p. 142-148, 2021.

Chicago: Author-Date Style

Babuna Kobaner, Goncagül, and Esen Özkaya. 2021. “Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey.” Journal of Child 21, no. 2: 142-148. https://doi.org/10.26650/jchild.2021.925276

Chicago: Humanities Style

Babuna Kobaner, Goncagül, and Esen Özkaya. “Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey.” Journal of Child 21, no. 2 (Nov. 2024): 142-148. https://doi.org/10.26650/jchild.2021.925276

Harvard: Australian Style

Babuna Kobaner, G & Özkaya, E 2021, 'Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey', Journal of Child, vol. 21, no. 2, pp. 142-148, viewed 15 Nov. 2024, https://doi.org/10.26650/jchild.2021.925276

Harvard: Author-Date Style

Babuna Kobaner, G. and Özkaya, E. (2021) ‘Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey’, Journal of Child, 21(2), pp. 142-148. https://doi.org/10.26650/jchild.2021.925276 (15 Nov. 2024).

MLA

Babuna Kobaner, Goncagül, and Esen Özkaya. “Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey.” Journal of Child, vol. 21, no. 2, 2021, pp. 142-148. [Database Container], https://doi.org/10.26650/jchild.2021.925276

Vancouver

Babuna Kobaner G, Özkaya E. Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey. Journal of Child [Internet]. 15 Nov. 2024 [cited 15 Nov. 2024];21(2):142-148. Available from: https://doi.org/10.26650/jchild.2021.925276 doi: 10.26650/jchild.2021.925276

ISNAD

Babuna Kobaner, Goncagül - Özkaya, Esen. “Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey”. Journal of Child 21/2 (Nov. 2024): 142-148. https://doi.org/10.26650/jchild.2021.925276

Volume 21, Issue 22021, P. 142-148

TIMELINE

Submitted	21.04.2021
Accepted	03.08.2021
Published Online	07.09.2021

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