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OBJECTIVE To investigate the characteristics of severe cutaneous adverse reactions (SCARs) induced by proton pump inhibitors (PPIs) and provide references for clinical safe use of drugs. METHODS Case reports of SCARs caused by PPIs were retrieved from Pubmed, CNKI, Wanfang and VIP databases up to June 2024. Information such as demographic characteristics, drug use, occurrence time, types, clinical manifestations, treatment measures and outcomes of patients was collected, and descriptive statistical analysis was conducted. RESULTS A total of 22 patients were included. There were 8 males (36.4%) and 14 females (63.6%), aged from 23 to 89 years, with an average age of years. The PPIs involved included omeprazole in 10 cases, esomeprazole in 6 cases, pantoprazole in 3 cases, and lansoprazole in 3 cases. SCARs occurred from 1 to 45 days, with an average time of days after treatment, and 18 cases (94.7%) within 3 weeks. Ten cases were diagnosed as Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), 7 cases were diagnosed as drug reaction with eosinophilia and systemic symptom (DRESS), and 5 cases were diagnosed as acute generalized exanthematous pustulosis (AGEP). The clinical symptoms and laboratory indicators of 18 patients (81.8%) were improved after discontinuation and treatment with glucocorticoid and/or globulin, but three patients died of multiple organ failure eventually, and one patient was discharged automatically. CONCLUSION SCARs can be caused by a variety of PPIs, with omeprazole and esomeprazole being relatively more common, and mainly manifest as SJS/TEN and DRESS. Patients should be closely monitored for any allergic symptoms such as fever and rash within 6 weeks of using PPIs. Once SCARs are suspected, the drug should be stopped in time, and symptomatic supportive treatment such as glucocorticoids should be provided if necessary.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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