Abstract: Objective: To retrospectively analyze the clinical data of patients with severe ctaneous adverse reactions (SCARs) admitted to Qingdao Municipal Hospital from 2019 to 2023, so as to provide references for rational prevention, reduction of complications, and improvement of cure rates. Methods: Clinical data of 40 inpatients with SCARs admitted to Qingdao Municipal Hospital from July 2019 to December 2023 were collected through the electronic medical record system. The clinical characteristics of patients with different disease types were analyzed. Results: Among the 40 cases of SCARs, there were 15 males and 25 females, including 32 cases of Stevens-Johnson Syndrome (SJS), 4 cases of acute generalized exanthematous pustulosis (AGEP), 3 cases of exfoliative dermatitis (ED), and 1 case of toxic epidermal necrolysis (TEN). 25 patients had fever, 3 had superficial lymphadenopathy, 10 had mucosal involvement, 10 had abnormal liver function , 1 case had hyperbilirubinemia with jaundice, and 1 case had acute renal failure. Suspicious sensitizing drugs were discontinued, and early adequate glucocorticoid therapy was administered. Additionally, 5 cases were treated with TNF-α inhibitors, 3 with cyclosporine, and 2 with intravenous immunoglobulin (IVIG). Six patients were discharged cured, 34 were discharged improved, and there were no deaths. The sensitizing drugs were confirmed in 36 cases: 34 cases occurred after the first drug use, and 2 cases after repeated drug use. Among the sensitizing drugs, 15 were antibiotics, 12 were traditional Chinese medicines (TCMs) and proprietary Chinese medicines, 4 were antipyretic and analgesic drugs, 3 were antitumor drugs, and 2 were antiepileptic drugs. Conclusions: SCARs present diverse clinical manifestations, including erythema, desquamation, blisters, mucosal involvement, high fever, and organ function impairment. SJS is the most common type, and antibiotics are the main sensitizing drugs. Early and adequate systemic application of glucocorticoids and IVIG is the key to the treatment of severe drug eruptions.

Key words: severe cutaneous adverse reactions, SJS, AGEP, TEN, antibiotics