Biomaterial Database

Severe adverse skin reactions to nonsteroidal antiinflammatory drugs: A review of the literature. 2010

Kristina E Ward, and Raoul Archambault, and Tracey L Mersfelder

College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA. kward@uri.edu

OBJECTIVE Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) are described. CONCLUSIONS A search of the English- language medical literature was conducted to identify studies and cases of SJS and TEN associated with NSAIDs and cyclooxygenase-2-selective NSAIDs available in the United States. Several epidemiologic studies, case reports, and case series involving SJS and TEN associated with NSAIDs were identified. Of the available NSAIDs, oxicam derivatives appeared to have the greatest association with SJS and TEN. The relative risks reported with other NSAIDs are much lower. The risk with cyclooxygenase-2-selective NSAIDs and meloxicam is less clear, since all were introduced after the completion of the epidemiologic studies. SJS or TEN from NSAIDs and cyclooxygenase-2-selective NSAIDs appears to affect the same patient population as other medications that cause SJS or TEN. The risk of SJS or TEN caused by NSAIDs is extremely low (less than 2 per 1 million users per week for oxicam derivatives, less than 1 per 1 million users per week for other NSAIDs, and 6 cases per 1 million person-years for celecoxib). Aspirin is not typically associated with SJS or TEN. Of the other salicylates, SJS or TEN has only been reported with diflunisal. CONCLUSIONS The risk of SJS or TEN in patients receiving NSAIDs is extremely low; older patients, women, and patients within the first month of treatment initiation appear to have the greatest risk. Health care providers and patients should be aware of the signs and symptoms of SJS and TEN.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000367	Age Factors	Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.	Age Reporting,Age Factor,Factor, Age,Factors, Age
D000894	Anti-Inflammatory Agents, Non-Steroidal	Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions. They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.	Analgesics, Anti-Inflammatory,Aspirin-Like Agent,Aspirin-Like Agents,NSAID,Non-Steroidal Anti-Inflammatory Agent,Non-Steroidal Anti-Inflammatory Agents,Nonsteroidal Anti-Inflammatory Agent,Anti Inflammatory Agents, Nonsteroidal,Antiinflammatory Agents, Non Steroidal,Antiinflammatory Agents, Nonsteroidal,NSAIDs,Nonsteroidal Anti-Inflammatory Agents,Agent, Aspirin-Like,Agent, Non-Steroidal Anti-Inflammatory,Agent, Nonsteroidal Anti-Inflammatory,Anti-Inflammatory Agent, Non-Steroidal,Anti-Inflammatory Agent, Nonsteroidal,Anti-Inflammatory Analgesics,Aspirin Like Agent,Aspirin Like Agents,Non Steroidal Anti Inflammatory Agent,Non Steroidal Anti Inflammatory Agents,Nonsteroidal Anti Inflammatory Agent,Nonsteroidal Anti Inflammatory Agents,Nonsteroidal Antiinflammatory Agents
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D012737	Sex Factors	Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.	Factor, Sex,Factors, Sex,Sex Factor
D013262	Stevens-Johnson Syndrome	Rare cutaneous eruption characterized by extensive KERATINOCYTE apoptosis resulting in skin detachment with mucosal involvement. It is often provoked by the use of drugs (e.g., antibiotics and anticonvulsants) or associated with PNEUMONIA, MYCOPLASMA. It is considered a continuum of Toxic Epidermal Necrolysis.	Drug-Induced Stevens Johnson Syndrome,Drug-Induced Stevens-Johnson Syndrome,Epidermal Necrolysis, Toxic,Lyell's Syndrome,Mycoplasma-Induced Stevens Johnson Syndrome,Mycoplasma-Induced Stevens-Johnson Syndrome,Nonstaphylococcal Scalded Skin Syndrome,Scalded Skin Syndrome, Nonstaphylococcal,Stevens Johnson Syndrome Toxic Epidermal Necrolysis,Stevens Johnson Syndrome Toxic Epidermal Necrolysis Spectrum,Stevens-Johnson Syndrome Toxic Epidermal Necrolysis,Stevens-Johnson Syndrome Toxic Epidermal Necrolysis Spectrum,Toxic Epidermal Necrolysis,Toxic Epidermal Necrolysis Stevens Johnson Syndrome,Toxic Epidermal Necrolysis Stevens Johnson Syndrome Spectrum,Toxic Epidermal Necrolysis Stevens-Johnson Syndrome,Toxic Epidermal Necrolysis Stevens-Johnson Syndrome Spectrum,Drug Induced Stevens Johnson Syndrome,Drug-Induced Stevens-Johnson Syndromes,Epidermal Necrolyses, Toxic,Lyell Syndrome,Lyell's Syndromes,Mycoplasma Induced Stevens Johnson Syndrome,Necrolyses, Toxic Epidermal,Necrolysis, Toxic Epidermal,Stevens Johnson Syndrome,Stevens-Johnson Syndrome, Drug-Induced,Stevens-Johnson Syndrome, Mycoplasma-Induced,Stevens-Johnson Syndromes, Drug-Induced,Syndrome, Lyell's,Syndrome, Mycoplasma-Induced Stevens-Johnson,Syndromes, Lyell's,Toxic Epidermal Necrolyses
D016907	Adverse Drug Reaction Reporting Systems	Systems developed for collecting reports from government agencies, manufacturers, hospitals, physicians, and other sources on adverse drug reactions.	Adverse Drug Reaction Reporting System,Drug Reaction Reporting Systems, Adverse
D052246	Cyclooxygenase 2 Inhibitors	A subclass of cyclooxygenase inhibitors with specificity for CYCLOOXYGENASE-2.	COX-2 Inhibitor,COX2 Inhibitor,Coxib,Cyclooxygenase 2 Inhibitor,Cyclooxygenase-2 Inhibitor,COX-2 Inhibitors,COX2 Inhibitors,Coxibs,Cyclooxygenase-2 Inhibitors,2 Inhibitor, Cyclooxygenase,COX 2 Inhibitor,COX 2 Inhibitors,Inhibitor, COX-2,Inhibitor, COX2,Inhibitor, Cyclooxygenase 2,Inhibitor, Cyclooxygenase-2,Inhibitors, COX-2,Inhibitors, COX2,Inhibitors, Cyclooxygenase 2,Inhibitors, Cyclooxygenase-2