Drug Induced Skin Reactions in Hospitalized Patients: Epidemiology and Management

One of the most frequent drug side effects that patients in hospitals describe is drug-induced skin responses (DISRs). While some rashes are benign and disappear on their own, others, such as Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson Syndrome (SJS), can be fatal. Quick diagnosis and treatment are very important for lowering the number of people who get sick and die. Nevertheless, information regarding the epidemiology and clinical spectrum of DISRs in Indian hospitalised populations is still scarce, particularly from Odisha.
Objectives: This study seeks to examine the prevalence, clinical manifestations, etiological agents, risk factors, and outcomes of drug-induced cutaneous reactions in hospitalised patients. It also seeks to assess the management strategies implemented and their efficacy in reducing complications.
Methods: A hospital-baseinvestigation was executed over one year (01 July 2024 to 01 July 2025) at two tertiary care institutions: Maharaja Jajati Keshari Medical College & Hospital, Jajpur, and PRM Medical College & Hospital, Mayurbhanj, Odisha. 1000 individuals who experienced cutaneous adverse drug reactions during their hospitalisation were encompassed. The clinical history, drug exposure, morphology of lesions, latency period, and systemic involvement were documented. The WHO-UMC criteria were used to figure out the cause, and the Hartwig and Siegel scale was used to rate the severity.
Results: Of the 1000 patients, the drug classes that were most likely to be the cause were antimicrobials (45.8%), anticonvulsants (21.3%), and NSAIDs (17.6%). The most common clinical patterns seen were maculopapular rash (38.5%), urticaria (19.4%), fixed drug eruptions (12.8%), and severe reactions like SJS/TEN (4.3%). A considerable proportion of cases (31.2%) were linked to polypharmacy. Most patients (85.1%) did well when the drug that was causing the problem was stopped right away and they got supportive care. In 14.6% of cases, systemic corticosteroids were necessary. There was a 0.6% death rate, mostly among people with TEN and serious systemic involvement.
Conclusion: Drug-induced skin reactions are a major problem in hospitals, with antimicrobials and anticonvulsants being the most common causes. Early identification, proper assessment of causality, and prompt management are crucial in reducing negative outcomes. This study emphasises the necessity for regular pharmacovigilance and drug monitoring programs in hospitals to more effectively prevent, identify, and manage drug-induced skin reactions (DISRs).