Toxidermias em Idade Pediátrica

Mafalda Machado; Maria J. Cruz; Alberto Mota

doi:10.29021/spdv.75.3.810

Mafalda Machado Aluna do Mestrado Integrado de Medicina na Faculdade de Medicina da Universidade do Porto
Maria J. Cruz Docente de Dermatologia e Venerologia, Licenciada em Dermatologia e Venerologia no Centro Hospitalar de São João, Porto
Alberto Mota Professor de Dermatologia e Venerologia da Faculdade de Medicina do Porto e Assistente Graduado de Dermatologia, Serviço de Dermatologia e Venerologia do Centro Hospitalar de São João EPE, Porto, Portugal

DOI: https://doi.org/10.29021/spdv.75.3.810

Palavras-chave: Criança, Erupção por Medicamentos, Hipersensibilidade a Medicamentos, Síndrome de Hipersensibilidade a Medicamentos, Síndrome de Stevens-Johnson

Resumo

As toxidermias em idade pediátrica são frequentes, contudo existem características específicas desta faixa etária pouco estudadas. Estas diferem frequentemente das toxidermias do adulto em termos de apresentação clínica, fármacos implicados, prognóstico e tratamento. O seu reconhecimento precoce e suspensão do fármaco causador são de extrema importância para diminuição do risco de morbimortalidade. O objetivo deste trabalho é rever as principais características que diferenciam as toxidermias da criança das do adulto, de forma a facilitar o seu reconhecimento e perceber como a sua investigação pode ser melhorada.

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Referências

Dilek N, Ozkol HU, Akbas A, Kilinc F, Dilek AR, Saral Y,

et al. Cutaneous drug reactions in children: a multicentric

study. Postepy Dermatol Alergol. 2014;31:368-71.

Rashed AN, Wong IC, Cranswick N, Hefele B, Tomlin

S, Jackman J, et al. Adverse drug reactions in children--

-International Surveillance and Evaluation (ADVISE): a

multicentre cohort study. Drug Saf. 2012;35:481-94.

Raucci U, Rossi R, Da Cas R, Rafaniello C, Mores N,

Bersani G, et al. Stevens-johnson syndrome associated

with drugs and vaccines in children: a case-control study.

PloS One. 2013;8:e68231.

Koh MJ, Tay YK. An update on Stevens-Johnson syndrome

and toxic epidermal necrolysis in children. Curr Opin

Pediatr. 2009;21:505-10.

Neubert A. Pharmacovigilance in pediatrics: current

challenges. Paediatr Drugs. 2012;14:1-5.

Lee WJ, Lee TA, Pickard AS, Caskey RN, Schumock GT.

Drugs associated with adverse events in children and

adolescents. Pharmacotherapy. 2014;34:918-26.

Darnis D, Mahe J, Vrignaud B, Guen CG, Veyrac G,

Jolliet P. Adverse drug reactions in pediatric emergency

medicine. Ann Pharmacother. 2015;49:1298-304.

Durrieu G, Batz A, Rousseau V, Bondon-Guitton E, Petiot

D, Montastruc JL. Use of administrative hospital database

to identify adverse drug reactions in a Pediatric University

Hospital. Eur J Clin Pharmacol. 2014;70:1519-26.

Noguera-Morel L, Hernandez-Martin A, Torrelo A.

Cutaneous drug reactions in the pediatric population.

Pediatr Clin North Am. 2014;61:403-26.

Guerrini R, Zaccara G, la Marca G, Rosati A. Safety and

tolerability of antiepileptic drug treatment in children with

epilepsy. Drug Saf. 2012;35:519-33.

Pichler WJ, Adam J, Daubner B, Gentinetta T, Keller

M, Yerly D. Drug hypersensitivity reactions: pathomechanism

and clinical symptoms. Med Clin North Am.

;94:645-64, xv.

Star K, Noren GN, Nordin K, Edwards IR. Suspected

adverse drug reactions reported for children worldwide:

an exploratory study using VigiBase. Drug Saf.

;34:415-28.

Kaniwa N, Saito Y. The risk of cutaneous adverse reactions

among patients with the HLA-A* 31:01 allele who are

given carbamazepine, oxcarbazepine or eslicarbazepine:

a perspective review. Ther Adv Drug Saf. 2013;4:246-53.

Cheng CY, Su SC, Chen CH, Chen WL, Deng ST, Chung

WH. HLA associations and clinical implications in T-cell

mediated drug hypersensitivity reactions: an updated

review. J Immunol Res. 2014;2014:565320.

Amstutz U, Ross CJ, Castro-Pastrana LI, Rieder MJ, Shear

NH, Hayden MR, et al. HLA-A 31:01 and HLA-B 15:02

as genetic markers for carbamazepine hypersensitivity in

children. Clin Pharmacol Therap. 2013;94:142-9.

Pichler WJ. The p-i concept: pharmacological interaction

of drugs with immune receptors. World Allergy Organ J.

;1:96-102.

Heelan K, Shear NH. Cutaneous drug reactions in

children: an update. Paediatr Drugs. 2013;15:493-503.

Hoetzenecker W, Nageli M, Mehra ET, Jensen AN, Saulite

I, Schmid-Grendelmeier P, et al. Adverse cutaneous drug

eruptions: current understanding. Semin Immunopathol.

;38:75-86.

Song JE, Sidbury R. An update on pediatric cutaneous

drug eruptions. Clin Dermatol. 2014;32:516-23.

Chovel-Sella A, Ben Tov A, Lahav E, Mor O, Rudich H,

Paret G, et al. Incidence of rash after amoxicillin treatment

in children with infectious mononucleosis. Pediatrics.

;131:e1424-7.

Peroni A, Colato C, Zanoni G, Girolomoni G. Urticarial

lesions: if not urticaria, what else? The differential

diagnosis of urticaria: part II. Systemic diseases. J Am

Acad Dermatol. 2010;62:557-70; quiz 71-2.

Peroni A, Colato C, Schena D, Girolomoni G. Urticarial

lesions: if not urticaria, what else? The differential

diagnosis of urticaria: part I. Cutaneous diseases. J

AmAcad Dermatol. 2010;62:541-55; quiz 55-6.

Blanca-Lopez N, Cornejo-Garcia JA, Plaza-Seron MC,

Dona I, Torres-Jaen MJ, Canto G, et al. Hypersensitivity

to nonsteroidal anti-inflammatory drugs in children

and adolescents: cross-intolerance reactions. J Investig

Allergol Clin Immunol. 2015;25:259-69.

Sokumbi O, Wetter DA. Clinical features, diagnosis,

and treatment of erythema multiforme: a review for the

practicing dermatologist. Int J Dermatol. 2012;51:889-

Keller N, Gilad O, Marom D, Marcus N, Garty BZ.

Nonbullous Erythema multiforme in hospitalized children:

a 10-year survey. Pediatr Dermatol. 2015;32:701-3.

Finkelstein Y, Soon GS, Acuna P, George M, Pope E, Ito

S, et al. Recurrence and outcomes of Stevens-Johnson

syndrome and toxic epidermal necrolysis in children.

Pediatrics. 2011;128:723-8.

Levi N, Bastuji-Garin S, Mockenhaupt M, Roujeau JC,

Flahault A, Kelly JP, et al. Medications as risk factors

of Stevens-Johnson syndrome and toxic epidermal

necrolysis in children: a pooled analysis. Pediatrics.

;123:e297-304.

Treat JR. Skin signs of severe systemic medication reactions.

Curr Probl Pediatr Adolesc Health Care. 2012;42:193-7.

Heng YK, Yew YW, Lim DS, Lim YL. An update of fixed drug

eruptions in Singapore. J Eur Acad Dermatol Venereol.

;29:1539-44.

Morelli JG, Tay YK, Rogers M, Halbert A, Krafchik B,

Weston WL. Fixed drug eruptions in children. J Pediatr.

;134:365-7.

Mathur AN, Mathes EF. Urticaria mimickers in children.

Dermatolc Ther. 2013;26:467-75.

Kardaun SH, Kuiper H, Fidler V, Jonkman MF. The

histopathological spectrum of acute generalized

exanthematous pustulosis (AGEP) and its differentiation

from generalized pustular psoriasis. J Cutan

Pathol.2010;37:1220-9.

Ozmen S, Misirlioglu ED, Gurkan A, Arda N, Bostanci

I. Is acute generalized exanthematous pustulosis

an uncommon condition in childhood? Allergy.

;65:1490-2.

Ropars N, Darrieux L, Tisseau L, Safa G. Acute generalized

exanthematous pustulosis associated with primary Epstein-

Barr virus infection. JAAD Case Rep. 2015;1:9-11.

Kardaun SH, Sekula P, Valeyrie-Allanore L, Liss Y, Chu

CY, Creamer D, et al. Drug reaction with eosinophilia

and systemic symptoms (DRESS): an original multisystem

adverse drug reaction. Results from the prospective

RegiSCAR study. Br J Dermatol. 2013;169:1071-80.

Pirmohamed M, Friedmann PS, Molokhia M, Loke YK,

Smith C, Phillips E, et al. Phenotype standardization

for immune-mediated drug-induced skin injury. Clin

Pharmacol Therap. 2011;89:896-901.

Ahluwalia J, Abuabara K, Perman MJ, Yan AC. Human

herpesvirus 6 involvement in paediatric drug hypersensitivity

syndrome. Br J Dermatol. 2015;172:1090-5.

Yang MS, Kang MG, Jung JW, Song WJ, Kang HR, Cho

SH, et al. Clinical features and prognostic factors in severe

cutaneous drug reactions. Int Arch Allergy Immunol.

;162:346-54.

Sasidharanpillai S, Sabitha S, Riyaz N, Binitha MP,

Muhammed K, Riyaz A, et al. Drug Reaction with

Eosinophilia and Systemic Symptoms in Children: A

Prospective Study. Pediatr Dermatol. 2016;33:e162-5.

Monteiro AF, Rato M, Martins C. Drug-induced

photosensitivity: Photoallergic and phototoxic reactions.

Clin Dermatol. 2016;34:571-81.

Lankerani L, Baron ED. Photosensitivity to exogenous

agents. J Cutan Med Surg. 2004;8:424-31.

Cook N, Freeman S. Photosensitive dermatitis due to

sunscreen allergy in a child. The Australas J Dermatol.

;43:133-5.

Sheu J, Hawryluk EB, Guo D, London WB, Huang JT.

Voriconazole phototoxicity in children: a retrospective

review. J Am Acad Dermatol. 2015;72:314-20.

Varallo FR, Planeta CS, Herdeiro MT, Mastroianni

PC. Imputation of adverse drug reactions: Causality

assessment in hospitals. PloS One. 2017;12:e0171470.

Ferner RE. Adverse drug reactions in dermatology. Clin

Exp Dermatol. 2015;40:105-9; quiz 9-10.

Antunes J BS, Prates S, Amaro C, Leiria-Pinto P. Alergia

a fármacos com manifestações cutâneas - abordagem

diagnóstica. Rev Soc Port Dermatol Venereol.

;70:277-89.

Bellini V, Pelliccia S, Lisi P. Drug- and virus- or bacteriainduced

exanthems: the role of immunohistochemical

staining for cytokines in differential diagnosis. Dermatitis.

;24:85-90.

Seitz CS, Rose C, Kerstan A, Trautmann A. Drug-induced

exanthems: correlation of allergy testing with histologic

diagnosis. J Am Acad Dermatol. 2013;69:721-8.

Wang EC, Lee JS, Tan AW, Tang MB. Fas-ligand staining

in non-drug- and drug-induced maculopapular rashes. J

Cutan Pathol. 2011;38:196-201.

Polak ME, Belgi G, McGuire C, Pickard C, Healy E, Friedmann

PS, et al. In vitro diagnostic assays are effective

during the acute phase of delayed-type drug hypersensitivity

reactions. Br J Dermatol. 2013;168:539-49.

Chung WH, Wang CW, Dao RL. Severe cutaneous adverse

drug reactions. J Dermatol. 2016;43:758-66.

Wolff K, Johnson RA, Saavedra AP. Fitzpatrick's Colour

Atlas & Synopsis of Clinical Dermatology. 6th ed. London:

McGraw Hill;2009.

Britton P, Deng L. Intravenous immunoglobulin in the

treatment of childhood Stevens Johnson syndrome. J

Paediatr Child Health. 2011;47:392-5.

Romero-Tapia SJ, Camara-Combaluzier HH, Baeza-

Bacab MA, Cerino-Javier R, Bulnes-Mendizabal DP,

Virgen-Ortega C. Use of intravenous immunoglobulin

for Stevens-Johnson syndrome and toxic epidermal

necrolysis in children: Report of two cases secondary to

anticonvulsants. Allergol Immunopathol. 2015;43:227-9.

Newell BD, Moinfar M, Mancini AJ, Nopper AJ.

Retrospective analysis of 32 pediatric patients with

anticonvulsant hypersensitivity syndrome (ACHSS).

Pediatr Dermatol. 2009;26:536-46.

Calistru AM, Cunha AP, Azevedo F. Toxidermias - estudo

dos casos internados num hospital central (2000-2010).

Rev Soc Port Dermatol Venereol. 2011;69:585-92.

Batel-Marques F, Penedones A, Mendes D, Alves C.

Outcomes from the first 6 years of operation of the

Central Portugal p0harmacovigilance Unit. J Patient Saf.

(in press).