Spectrum of Cutaneous Adverse Drug Reactions in a Tertiary Care Hospital in Bangladesh

Open Access

Abstract

Background: Cutaneous adverse drug reactions represent a significant clinical challenge in dermatology, encompassing a broad spectrum of morphological patterns ranging from mild exanthems to life-threatening severe cutaneous adverse reactions. Data on their spectrum in Bangladesh remain limited. Objective: To evaluate the clinical spectrum, causative drugs, and severity of cutaneous adverse drug reactions among hospitalized adult patients. Methods & Materials: This prospective cohort study was conducted at at the Department of Dermatology and Venereology, Bikrampur Bhuiyan Medical College and Hospital, Munshiganj, Bangladesh from January to December 2025. A total of 47 adult patients with suspected cutaneous adverse drug reactions were enrolled using purposive sampling. Clinical patterns were documented through dermatological examination, and causality assessment was performed using the Naranjo adverse drug reaction probability scale. Data were analyzed using SPSS version 23.0. Results: Among 47 patients, the mean age was 42.6 ± 15.3 years, with a female predominance of 57.4% (n=27). Morbilliform exanthema was the most frequent pattern (34.0%), followed by urticarial reactions (21.3%) and fixed drug eruptions (17.0%). Stevens-Johnson syndrome and toxic epidermal necrolysis accounted for 12.8% of cases. Antibiotics were the most commonly implicated drug class (44.7%), followed by anticonvulsants (19.1%). Severe cutaneous adverse reactions were significantly associated with anticonvulsant use (p<0.01). Conclusion: Cutaneous adverse drug reactions in Bangladeshi adults demonstrate a diverse clinical spectrum, with morbilliform exanthema being most common. Antibiotics and anticonvulsants are the leading causative agents. Prompt recognition and early withdrawal of offending drugs are crucial to reduce morbidity and mortality.