최근 5년간 약진으로 입원한 환자의 고찰 - 임상양상 및 검사소견$(1986{\sim}1990)$ -

Drug Eruptions of In-patients During a 5-Year Period - Clinical Types and Laboratory $Findings(1986{\sim}1990)$ -

저자들은 1986년 1월부터 1990년 12월까지 서울대병원 피부과에 약진으로 입원한 환자의 임상양상 및 검사소견을 요약하면 다음과 같다. 1) 최근 5년간 약진으로 입원한 환자는 53명으로 연 평균 10.8명이었다. 2) 피부발진의 임상 형태는 발진형 발진(30.8%), Stevens-Johnson 증후군(23.1%), 급성담마진(11.5%), 중독성 표피 괴사융해증(11.5%), 다형 홍반(9.6%), 고정 약진(5.8%), 광과민증(3.8%), 태선양약진(1.9%)의 순이었다. 3) 원인약제는 diphenylhydantoin, ampicillin, acetylsalicylic acid, carbamazepine이 흔하였고 이전 10년간의 원인약제와 비교하여 sulfonamide의 감소를 보였다. 4) 검사소견으로 간기능 검사의 이상이 32.7%이었으며 백혈구 증다증이 26.5%에서, 호산구 증다증이 16.3%에서 나타났다. 5) 동반된 증상으로는 소양증(55.1% )과 발열(51.0%)이 흔히 관찰되었다. 이상의 결과를 1976년에서 1955년까지의 결과와 비교하여 보면 연평균 환자수는 큰변화를 보이지 않으나 피부과 입원환자 중에 차지하는 비율은 8.9%에서 4.67%로 감소하였으며 원인약제는 sulfonamide의 감소를 보였다.

Background: Drug eruptions are one of the most frequently observed adverse reaction to drugs. Method: We analysed clinical types and laboratory findings of in-patients during a 5-year $period(1986{\sim}1990)$ who were diagnosed as drug eruption at the department of dermatology. Seoul National University Hospital. These findings were compared with the results of previous 10-year period. Results : Fifty-four patients(10.8/year) were diagnosed as drug eruption. The number of patients was not markedly changed compared with 12.7 patients per a year during previous 10-year period. but the proportion of drug eruption compared with total in-patient of the department of dermatology was diminished from 8.89% to 4.67%. The cutaneous manifestations of drug eruptions in the order of frequency were as follows: exanthematous eruption. Stevens-Johnson syndrome, urticaria, toxic epidermal necrolysis, erythema multiforme, fixed drug eruption, photosensitivity, lichenoid drug eruption. The frequent causative agents of drug eruptions were diphenylhydantoin, ampicillin, acetylsalicylic acid. carbamazepine. Abnormal liver function tests(32.7%), leukocytosis(26.5%) and hypereosinophilia(16.3%) were commonly associated with drug eruptions. Conclusion: The result of this study showed various clinical types and many causative agents of the drug eruption. The main groups of causative agents have remained same but the sulphonamide were decreased in recent years.