Clinical Manifestations and Prognosis Factors in Severe Cutaneous Adverse Drug Reaction (Scadr)
DOI:
https://doi.org/10.46799/jhs.v6i8.2674Keywords:
SCADR, clinical manifestations, prognosis factorsAbstract
Severe Cutaneous adverse drug reaction (SCADR) is a severe skin reaction due to the use of drugs that can be life-threatening. This article describes the clinical manifestations and prognosis factors that affect SCADR patients. The most common types of SCADR were Stevens-Johnson Syndrome (SSJ) and Toxic Epidermal Necrolysis (TEN). The drugs that most often trigger are antibiotics and anticonvulsants. The main clinical manifestations include erythematosa skin lesions, epidermal necrolysis, and mucosal involvement. Significant prognosis factors include the extent of the affected skin area, internal organ involvement, and SCORTEN score. Patients with high SCORTEN scores have a greater risk of mortality. Early treatment and discontinuation of trigger drugs are key factors in improving clinical outcomes. The conclusion is early recognition of clinical manifestations of SCADR as well as assessment of prognosis factors can be helpful in patient management and reduce the risk of serious complications. The study also highlights the importance of educating medical personnel in detecting and managing severe drug reactions.
References
Abbas, M., Moussa, M., & Akel, H. (2020). Type I hypersensitivity reaction.
Bajwa, S. F., & Mohammed, R. H. (2020). Type II hypersensitivity reaction.
Bellón, T. (2019). Mechanisms of severe cutaneous adverse reactions: recent advances. Drug Safety, 42(8), 973–992.
Chen, C., Chen, Y., Chu, M., Wang, C., Hui, R., Lu, C., Hsiao, Y., Chu, C., Chang, M. M., & Cheung, C. (2021). The risk of anti‐osteoporotic agent‐induced severe cutaneous adverse drug reactions and their association with HLA. Journal of the European Academy of Dermatology and Venereology, 35(3), 712–720.
Crisafulli, G., Franceschini, F., Caimmi, S., Bottau, P., Liotti, L., Saretta, F., Bernardini, R., Cardinale, F., Mori, F., & Caffarelli, C. (2019). Mild cutaneous reactions to drugs. Acta Bio-Medica: Atenei Parmensis, 90(3-S), 36–43.
Damayanti, D., Umborowati, M. A., Anggraeni, S., Prakoeswa, C. R. S., Hutomo, M., & Sukanto, H. (2019). Clinicoepidemiological profile of severe cutaneous adverse drug reaction: a retrospective study. Berkala Ilmu Kesehatan Kulit Dan Kelamin, 31(1), 1–6.
Del Pozzo‐Magaña, B. R., & Liy‐Wong, C. (2024). Drugs and the skin: A concise review of cutaneous adverse drug reactions. British Journal of Clinical Pharmacology, 90(8), 1838–1855.
Deng, M., Su, Y., Wu, R., Li, S., Tang, G., Kuang, Q., Luo, X., Zhu, Y., & Shen, W. (2023). Clinical features and prognostic factors of severe cutaneous adverse drug reactions: a single-center retrospective study of 209 cases in China. International Immunopharmacology, 114, 109530.
Hosohata, K., Inada, A., Oyama, S., Niinomi, I., Wakabayashi, T., & Iwanaga, K. (2019). Adverse cutaneous drug reactions associated with old-and new-generation antiepileptic drugs using the Japanese pharmacovigilance database. Clinical Drug Investigation, 39, 363–368.
Lady Aqnes Kurniawati, Lady, Muhammad Ilham Aldika Akbar, M., Budi Utomo, B., & Aditiawarman, A. (2021). Risk Factor of Preeclampsia in a Secondary Indonesian Hospital: A Case-Control Study. Indian Journal of Forensic Medicine & Toxicology, 15(3), 3474–3482.
Lee, H. Y., Thirumoorthy, T., & Pang, S. M. (2014). Acute generalized exanthematous pustulosis (AGEP) in Singapore. Clinical and Translational Allergy, 4, 1.
Machoń, N., Lewandowska, J., Zdanowska, N., Placek, W., & Owczarczyk-Saczonek, A. (2022). Cutaneous Adverse Drug Reactions (CADRs)—Statistical Analysis of the Causal Relationship between the Drug, Comorbidities, Cofactors, and the Cutaneous Reaction—A Single-Centered Study. International Journal of Environmental Research and Public Health, 19(13), 7982.
Maharani, P. N., Suwarsa, O., & Prodjosoewojo, S. (2020). Clinical Profile of Adverse Cutaneous Drug Reactions in Patients with Human Immunodeficiency Virus. Althea Medical Journal, 7(4), 200–205.
Manieri, E., Dondi, A., Neri, I., & Lanari, M. (2023). Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome in childhood: a narrative review. Frontiers in Medicine, 10, 1108345.
Modi, A., Desai, M., Shah, S., & Shah, B. (2019). Analysis of cutaneous adverse drug reactions reported at the regional ADR monitoring center. Indian Journal of Dermatology, 64(3), 250.
Mustafa, S. S., Ostrov, D., & Yerly, D. (2018). Severe cutaneous adverse drug reactions: presentation, risk factors, and management. Current Allergy and Asthma Reports, 18, 1–9.
Primisawitri, P. P., & Mawardi, P. (2022). The Correlation of Neutrophil–Lymphocyte Ratio and Eosinophil Count with SCORTEN in SJS/TEN. Clinical, Cosmetic and Investigational Dermatology, 547–556.
Putri, O. E., Oktavriana, T., Octarica, S. G., Lauda, B., Anandita, S. P., & Oktaviani, T. (2024). Profile And Risk Factors of Stevens Johnson Syndrome–Toxic Epidermal Necrolysis on Adult Patients in Dr. Moewardi General Hospital Surakarta from January 2019–December 2022. Health and Medical Journal, 6(2), 135–144.
Usman, N., & Annamaraju, P. (2023). Type III hypersensitivity reaction. In StatPearls [Internet]. StatPearls Publishing.
Zambernardi, A., & Label, M. (2018). Cutaneous adverse drug reactions: how to identify the trigger. Actas Dermo-Sifiliográficas (English Edition), 109(8), 699–707.
Zhang, C., Van, D. N., Hieu, C., & Craig, T. (2019). Drug-induced severe cutaneous adverse reactions: Determine the cause and prevention. Annals of Allergy, Asthma & Immunology, 123(5), 483–487.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Triasari Oktavriana, Benedikta Lauda, Osdatilla Esa Putri

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under aCreative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.