本研究收集藥物引起嚴重皮膚不良反應，須住院治療的病患，包括多形性紅斑（erythema multiforme, EM）、史帝芬氏-強生症候群（Stevens-Johnson syndrome, SJS）及毒性表皮壞死溶解症（toxic epidermal necrolysis, TEN）。根據國際疾病分類（International Classification of Disease, ICD-9）代碼695.1搜尋病患出院診斷摘要，回顧林口長庚醫院2002年所有住院病患的病歷，共有103位案例納入此研究中，其中包括多形性紅斑40例，史帝芬氏-強生症候群56例，毒性表皮壞死溶解症7例，死亡率分別為多形性紅斑2.5%，史帝芬氏-強生症候群8.9%，毒性表皮壞死溶解症42.8%。在40位多形性紅斑案例中，有50%是非藥物所引起的，但史帝芬氏-強生症候群及毒性表皮壞死溶解症則多是藥物造成的。就藥物種類而言，以抗癲癇藥佔49%、抗生素17%、非類固醇抗發炎藥及allopurinol各12%最為常見。就藥物本身而言，以carbamazepine（17例）、phenytoin（7例）、allopurinol（7例）發生的比例最高。
 

Background: To evaluate drug-induced severe cutaneous adverse reactions are an important source of information.
Methods: A retrospective study of based on International Classification of Disease-9 (ICD-9) coding to obtain severe cutaneous adverse reactions including erythema multiforme (EM), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) requiring hospitalization and to determine which drug therapies were associated with these reactions. We reviewed the clinical records of all patients who were hospitalized with these discharge diagnoses at Chang Gung Memorial Hospital during 2002.
Results: A total of 103 suspected cases were identified in the study; they included 40 cases of EM, 56 cases of SJS, and 7 cases of TEN. The mortality rate was 2.5% for EM, 8.9% for SJS, and 42.8% for TEN. Among the 40 patients of EM, a half cases were not drug related; SJS and TEN were responsible for drug-induced severe cutaneous adverse reactions in the study. The drug most commonly involved were anticonvulants (49%) followed by antibiotics (17%), nonsteroidal anti-inflammatory drugs and allopurinol (12%).
Conclusion: Carbamazepine, phenytoin and allopurinol were the suspected agents associated with drug-induced adverse reactions.