Abstract：
BACKGROUND: There are limited data on severe cutaneous adverse reactions (SCARs) associated with antiepileptic medications. The current study aims to investigate the clinical and epidemiological characteristics of antiepileptic medication-induced SCARs in hospitalized children.
METHODS: The current five-year retrospective study was conducted at Isfahan University of Medical Sciences, Iran. This study included all children with a definite diagnosis of SCARs secondary to the use of antiepileptic medications based on the world health organization (WHO) definition. In our study SCARs were categorized into three fields: Hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).
RESULTS: Among 259 children with SCARs induced by antiepileptic medications, 199 (76.83%), 42 (16.22%), and 18 (6.95%) had hypersensitivity syndrome, DRESS, and SJS/TEN, respectively. Phenobarbital was the most common offending drug in all types of SCARs. The multinomial logistic regression model revealed that lymphadenopathy increased the occurrence of DRESS by 35 times compared to hypersensitivity syndrome (P < 0.001). Girls were at risk of SJS/TEN approximately 6 times more than boys (P = 0.027). Age (P = 0.021), weight (P = 0.036), and mucosal involvement (P < 0.001) affected the hospitalization duration in children with SCARs related to antiepileptic medication.
CONCLUSIONS: There are some similarities and differences in the clinical and epidemiological features of Iranian children suffering from antiepileptic medication-induced SCARs.
METHODS: The current five-year retrospective study was conducted at Isfahan University of Medical Sciences, Iran. This study included all children with a definite diagnosis of SCARs secondary to the use of antiepileptic medications based on the world health organization (WHO) definition. In our study SCARs were categorized into three fields: Hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).
RESULTS: Among 259 children with SCARs induced by antiepileptic medications, 199 (76.83%), 42 (16.22%), and 18 (6.95%) had hypersensitivity syndrome, DRESS, and SJS/TEN, respectively. Phenobarbital was the most common offending drug in all types of SCARs. The multinomial logistic regression model revealed that lymphadenopathy increased the occurrence of DRESS by 35 times compared to hypersensitivity syndrome (P < 0.001). Girls were at risk of SJS/TEN approximately 6 times more than boys (P = 0.027). Age (P = 0.021), weight (P = 0.036), and mucosal involvement (P < 0.001) affected the hospitalization duration in children with SCARs related to antiepileptic medication.
CONCLUSIONS: There are some similarities and differences in the clinical and epidemiological features of Iranian children suffering from antiepileptic medication-induced SCARs.
摘要：
背景：关于与抗癫痫药物相关的严重皮肤不良反应（SCAR）的数据有限。本研究旨在探讨住院儿童抗癫痫药物致SCAR的临床和流行病学特征。
方法：目前为期五年的回顾性研究是在伊斯法罕医科大学进行的，伊朗。根据世界卫生组织（WHO）的定义，这项研究包括所有明确诊断为使用抗癫痫药物继发的SCAR的儿童。在我们的研究中，SCAR分为三个领域：超敏反应综合征，嗜酸粒细胞增多和全身症状的药物反应（DRESS），和史蒂文斯-约翰逊综合征（SJS）/中毒性表皮坏死松解症（TEN）。
结果：在259名抗癫痫药物诱导的SCAR儿童中，199（76.83%），42（16.22%），18人（6.95%）有超敏反应综合征，连衣裙,和SJS/TEN，分别。苯巴比妥是所有类型SCAR中最常见的犯罪药物。多项logistic回归模型显示，与超敏反应综合征相比，淋巴结肿大使DRESS的发生率增加了35倍（P<0.001）。女孩患SJS/TEN的风险是男孩的6倍（P=0.027）。年龄（P=0.021），体重（P=0.036），粘膜受累（P<0.001）影响了与抗癫痫药物相关的SCAR患儿的住院时间。
结论：伊朗儿童患有抗癫痫药物引起的SCAR的临床和流行病学特征有一些相似之处和不同之处。
方法：目前为期五年的回顾性研究是在伊斯法罕医科大学进行的，伊朗。根据世界卫生组织（WHO）的定义，这项研究包括所有明确诊断为使用抗癫痫药物继发的SCAR的儿童。在我们的研究中，SCAR分为三个领域：超敏反应综合征，嗜酸粒细胞增多和全身症状的药物反应（DRESS），和史蒂文斯-约翰逊综合征（SJS）/中毒性表皮坏死松解症（TEN）。
结果：在259名抗癫痫药物诱导的SCAR儿童中，199（76.83%），42（16.22%），18人（6.95%）有超敏反应综合征，连衣裙,和SJS/TEN，分别。苯巴比妥是所有类型SCAR中最常见的犯罪药物。多项logistic回归模型显示，与超敏反应综合征相比，淋巴结肿大使DRESS的发生率增加了35倍（P<0.001）。女孩患SJS/TEN的风险是男孩的6倍（P=0.027）。年龄（P=0.021），体重（P=0.036），粘膜受累（P<0.001）影响了与抗癫痫药物相关的SCAR患儿的住院时间。
结论：伊朗儿童患有抗癫痫药物引起的SCAR的临床和流行病学特征有一些相似之处和不同之处。
