Abstract
Cutaneous adverse drug reactions (CADRs) often have unanticipated and far-reaching consequences for the elderly patient, which may persist long after the initial event. The reasons for this are related to the presence of polypharmacy, multimorbidity, frailty, and geriatric syndromes in the elderly. Involvement of a geriatrician may be beneficial in the identification of previously unidentified geriatric issues and minimization of treatment-related adverse outcomes.
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Abbreviations
- AGEP:
-
Acute generalized exanthematous pustulosis
- AMD:
-
Age-related macular degeneration
- cADR:
-
Cutaneous adverse drug reaction
- DRESS:
-
Drug reaction with eosinophilia and systemic symptoms
- GBFDE:
-
Generalized bullous fixed drug eruption
- HCTZ:
-
Hydrochlorothiazide
- ICU:
-
Intensive care unit
- PIR:
-
Proportional impairment ratio
- SJS/TEN:
-
Stevens-Johnson syndrome/toxic epidermal necrolysis
References
Aarts S, Patel KV, Garcia ME, Van den Akker M, Verhey FRJ, Metsemakers JFM, Van Boxtel MPJ, Gudnason V, Jonsdottir MK, Siggeirsdottir K, Jonsson PV, Harris TB, Launer LJ (2015) Co-presence of multimorbidity and disability with frailty: an examination of heterogeneity in the frail older population. J Frailty Aging 4:131–138. https://doi.org/10.14283/jfa.2015.45
Agarwal V, O’Neill PJ, Cotton BA, Pun BT, Haney S, Thompson J, Kassebaum N, Shintani A, Guy J, Ely EW, Pandharipande P (2010) Prevalence and risk factors for development of delirium in BURN intensive care unit patients. J Burn Care Res 31:706–715. https://doi.org/10.1097/BCR.0b013e3181eebee9
Ahmed AR, Moy R (1982) Death in pemphigus. J Am Acad Dermatol 7:221–228
Alley E, Green R, Schuchter L (2002) Cutaneous toxicities of cancer therapy. Curr Opin Oncol 14:212–216
Ancelin ML (2006) Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ 332:455–459. https://doi.org/10.1136/bmj.38740.439664.DE
Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L, Roujeau JC (2011) The DRESS syndrome: a literature review. Am J Med 124:588–597. https://doi.org/10.1016/j.amjmed.2011.01.017
Chen Y-C, Chang C-Y, Cho Y-T, Chiu H-C, Chu C-Y (2013) Long-term sequelae of drug reaction with eosinophilia and systemic symptoms: a retrospective cohort study from Taiwan. J Am Acad Dermatol 68:459–465. https://doi.org/10.1016/j.jaad.2012.08.009
Chew ML, Mulsant BH, Pollock BG, Lehman ME, Greenspan A, Mahmoud RA, Kirshner MA, Sorisio DA, Bies RR, Gharabawi G (2008) Anticholinergic activity of 107 medications commonly used by older adults: anticholinergic activity of medication. J Am Geriatr Soc 56:1333–1341. https://doi.org/10.1111/j.1532-5415.2008.01737.x
Clegg A, Young JB (2011) Which medications to avoid in people at risk of delirium: a systematic review. Age Ageing 40:23–29. https://doi.org/10.1093/ageing/afq140
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013) Frailty in elderly people. Lancet 381:752–762. https://doi.org/10.1016/S0140-6736(12)62167-9
Crome P, Lally F (2011) Frailty: joining the giants. CMAJ Can Med Assoc J 183:889–890. https://doi.org/10.1503/cmaj.110626
Dodiuk-Gad RP, Olteanu C, Feinstein A, Hashimoto R, Alhusayen R, Whyte-Croasdaile S, Finkelstein Y, Burnett M, Sade S, Cartotto R, Jeschke M, Shear NH (2016) Major psychological complications and decreased health-related quality of life among survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis. Br J Dermatol 175:422–424. https://doi.org/10.1111/bjd.14799
Ellis G, Whitehead MA, Robinson D, O’Neill D, Langhorne P (2011) Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. BMJ 343:d6553–d6553. https://doi.org/10.1136/bmj.d6553
Evans SJ, Sayers M, Mitnitski A, Rockwood K (2014) The risk of adverse outcomes in hospitalized older patients in relation to a frailty index based on a comprehensive geriatric assessment. Age Ageing 43:127–132. https://doi.org/10.1093/ageing/aft156
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE (2012) Interventions for preventing falls in older people living in the community. In: The Cochrane Collaboration (ed) Cochrane database of systematic reviews. John Wiley & Sons, Ltd, Chichester
Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, Yu O, Crane PK, Larson EB (2015) Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med 175:401. https://doi.org/10.1001/jamainternmed.2014.7663
Gueudry J, Roujeau J-C, Binaghi M, Soubrane G, Muraine M (2009) Risk factors for the development of ocular complications of Stevens-Johnson syndrome and toxic epidermal necrolysis. Arch Dermatol 145:157. https://doi.org/10.1001/archdermatol.2009.540
Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T (2015) The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995–2010. BMC Med 13(74):74. https://doi.org/10.1186/s12916-015-0322-7
Gutiérrez-Valencia M, MartÃnez-Velilla N, Vetrano DL, Corsonello A, Lattanzio F, Ladrón-Arana S, Onder G (2017) Anticholinergic burden and health outcomes among older adults discharged from hospital: results from the CRIME study. Eur J Clin Pharmacol 73:1467. https://doi.org/10.1007/s00228-017-2312-5
Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M (2001) Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Arch Intern Med 161:1099–1105
Harari D, Hopper A, Dhesi J, Babic-Illman G, Lockwood L, Martin F (2007) Proactive care of older people undergoing surgery (‘POPS’): designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients. Age Ageing 36:190–196. https://doi.org/10.1093/ageing/afl163
Hsu DY, Brieva J, Sinha AA, Langan SM, Silverberg JI (2016) Comorbidities and inpatient mortality for pemphigus in the U.S.A. Br J Dermatol 174:1290–1298. https://doi.org/10.1111/bjd.14463
Hubbard RE, Peel NM, Samanta M, Gray LC, Mitnitski A, Rockwood K (2017) Frailty status at admission to hospital predicts multiple adverse outcomes. Age Ageing 46:801–806. https://doi.org/10.1093/ageing/afx081
Inouye SK, Bogardus ST, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, Cooney LM (1999) A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 340:669–676. https://doi.org/10.1056/NEJM199903043400901
Jackson JC, Pandharipande PP, Girard TD, Brummel NE, Thompson JL, Hughes CG, Pun BT, Vasilevskis EE, Morandi A, Shintani AK, Hopkins RO, Bernard GR, Dittus RS, Ely EW (2014) Depression, posttraumatic stress disorder, and functional disability in survivors of critical illness: results from the BRAIN ICU (bringing to light the risk factors and incidence of neuropsychological dysfunction in ICU survivors) investigation: a longitudinal cohort study. Lancet Respir Med 2:369–379. https://doi.org/10.1016/S2213-2600(14)70051-7
Joly P, Fontaine J, Roujeau J-C (2005) The role of topical corticosteroids in bullous pemphigoid in the elderly. Drugs Aging 22:571–576
Joly P, Roujeau J-C, Benichou J, Picard C, Dreno B, Delaporte E, Vaillant L, Incan MD, Plantin P, Bedane C, Young P, Bernard P, Bullous Diseases French Study Group (2002) A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med 346:321–327. https://doi.org/10.1056/NEJMoa011592
Jones C, Griffiths RD, Humphris G, Skirrow PM (2001) Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med 29:573–580
Kahlon S, Pederson J, Majumdar SR, Belga S, Lau D, Fradette M, Boyko D, Bakal JA, Johnston C, Padwal RS, McAlister FA (2015) Association between frailty and 30-day outcomes after discharge from hospital. Can Med Assoc J 187:799–804. https://doi.org/10.1503/cmaj.150100
Kowalski ML, Makowska JS, Blanca M, Bavbek S, Bochenek G, Bousquet J, Bousquet P, Celik G, Demoly P, Gomes ER, Niżankowska-Mogilnicka E, Romano A, Sanchez-Borges M, Sanz M, Torres MJ, De Weck A, Szczeklik A, Brockow K (2011) Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) – classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*: hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy 66:818–829. https://doi.org/10.1111/j.1398-9995.2011.02557.x
Lee WJ, Lee JL, Chang SE, Lee MW, Kang YK, Choi JH, Moon KC, Koh JK (2009) Cutaneous adverse effects in patients treated with the multitargeted kinase inhibitors sorafenib and sunitinib. Br J Dermatol 161:1045–1051. https://doi.org/10.1111/j.1365-2133.2009.09290.x
Lipowicz S, Sekula P, Ingen-Housz-Oro S, Liss Y, Sassolas B, Dunant A, Roujeau J-C, Mockenhaupt M (2013) Prognosis of generalized bullous fixed drug eruption: comparison with Stevens-Johnson syndrome and toxic epidermal necrolysis. Br J Dermatol 168:726–732. https://doi.org/10.1111/bjd.12133
Loukas E (2010) High-output heart failure in a patient with exfoliative Erythrodermic psoriasis. J Hosp Med 5:162–163
Maher RL, Hanlon J, Hajjar ER (2014) Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf 13:57–65. https://doi.org/10.1517/14740338.2013.827660
Marcantonio ER, Flacker JM, Wright RJ, Resnick NM (2001) Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 49:516–522
McDonald K, Trick L, Boyle J (2008) Sedation and antihistamines: an update. Review of inter-drug differences using proportional impairment ratios. Hum Psychopharmacol Clin Exp 23:555–570. https://doi.org/10.1002/hup.962
Miller DR, Oliveria SA, Berlowitz DR, Fincke BG, Stang P, Lillienfeld DE (2008) Angioedema incidence in US veterans initiating angiotensin-converting enzyme inhibitors. Hypertension 51:1624–1630. https://doi.org/10.1161/HYPERTENSIONAHA.108.110270
Morales ME, Purdue GF, Verity SM, Arnoldo BD, Blomquist PH (2010) Ophthalmic manifestations of Stevens-Johnson syndrome and toxic epidermal necrolysis and relation to SCORTEN. Am J Ophthalmol 150:505–510.e1. https://doi.org/10.1016/j.ajo.2010.04.026
Naidoo J, Page DB, Li BT, Connell LC, Schindler K, Lacouture ME, Postow MA, Wolchok JD (2015) Toxicities of the anti-PD-1 and anti-PD-L1 immune checkpoint antibodies. Ann Oncol 26:2375–2391. https://doi.org/10.1093/annonc/mdv383
Olteanu C, Shear NH, Chew HF, Hashimoto R, Alhusayen R, Whyte-Croasdaile S, Finkelstein Y, Burnett M, Ziv M, Sade S, Jeschke MG, Dodiuk-Gad RP (2017) Severe physical complications among survivors of Stevens–Johnson syndrome and toxic epidermal necrolysis. Drug Saf 41:277. https://doi.org/10.1007/s40264-017-0608-0
Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, Brummel NE, Hughes CG, Vasilevskis EE, Shintani AK, Moons KG, Geevarghese SK, Canonico A, Hopkins RO, Bernard GR, Dittus RS, Ely EW (2013) Long-term cognitive impairment after critical illness. N Engl J Med 369:1306–1316. https://doi.org/10.1056/NEJMoa1301372
Partridge JSL, Harari D, Martin FC, Dhesi JK (2014) The impact of pre-operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review. Anaesthesia 69(Suppl 1):8–16. https://doi.org/10.1111/anae.12494
Proksch E (1995) Antilipemic drug-induced skin manifestations. Hautarzt Z Für Dermatol Venerol Verwandte Geb 46:76–80
Robert C, Soria J-C, Spatz A, Le Cesne A, Malka D, Pautier P, Wechsler J, Lhomme C, Escudier B, Boige V, Armand J-P, Le Chevalier T (2005) Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol 6:491–500. https://doi.org/10.1016/S1470-2045(05)70243-6
Rockwood K (2005) A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J 173:489–495. https://doi.org/10.1503/cmaj.050051
Rolland Y, Morley JE (2016) Frailty and polypharmacy. J Nutr Health Aging 20:645–646. https://doi.org/10.1007/s12603-015-0510-3
Roujeau J-C, Lok C, Bastuji-Garin S, Mhalla S, Enginger V, Bernard P (1998) High risk of death in elderly patients with extensive bullous pemphigoid. Arch Dermatol 134:465. https://doi.org/10.1001/archderm.134.4.465
Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE (2008) The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 168:508–513. https://doi.org/10.1001/archinternmed.2007.106
Ruxton K, Woodman RJ, Mangoni AA (2015) Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: a systematic review and meta-analysis: anticholinergics and adverse outcomes in older adults. Br J Clin Pharmacol 80:209–220. https://doi.org/10.1111/bcp.12617
Rzany B, Partscht K, Jung M, Kippes W, Mecking D, Baima B, Prudlo C, Pawelczyk B, Messmer EM, Schuhmann M, Sinkgraven R, Büchner L, Büdinger L, Pfeiffer C, Sticherling M, Hertl M, Kaiser H-W, Meurer M, Zillikens D, Messer G (2002) Risk factors for lethal outcome in patients with bullous pemphigoid: low serum albumin level, high dosage of glucocorticosteroids, and old age. Arch Dermatol 138:903–908
Salahudeen MS, Duffull SB, Nishtala PS (2015) Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr 15:31. https://doi.org/10.1186/s12877-015-0029-9
Sassolas B, Haddad C, Mockenhaupt M, Dunant A, Liss Y, Bork K, Haustein UF, Vieluf D, Roujeau JC, Le Louet H (2010) ALDEN, an algorithm for assessment of drug causality in Stevens–Johnson syndrome and toxic epidermal necrolysis: comparison with case–control analysis. Clin Pharmacol Ther 88:60–68. https://doi.org/10.1038/clpt.2009.252
Sekula P, Dunant A, Mockenhaupt M, Naldi L, Bouwes Bavinck JN, Halevy S, Kardaun S, Sidoroff A, Liss Y, Schumacher M, Roujeau J-C, RegiSCAR Study Group (2013) Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. J Invest Dermatol 133:1197–1204. https://doi.org/10.1038/jid.2012.510
Woo J, Leung J (2014) Multi-morbidity, dependency, and frailty singly or in combination have different impact on health outcomes. Age (Dordr) 36:923–931. https://doi.org/10.1007/s11357-013-9590-3
Young JWS, Shear NH (2017) Cutaneous drug reactions in the elderly. Drugs Aging 34:655–672. https://doi.org/10.1007/s40266-017-0483-5
Zingale LC, Beltrami L, Zanichelli A, Maggioni L, Pappalardo E, Cicardi B, Cicardi M (2006) Angioedema without urticaria: a large clinical survey. Can Med Assoc J 175:1065–1070. https://doi.org/10.1503/cmaj.060535
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Young, J.W.S. (2019). Cutaneous Drug Reactions in the Elderly. In: Shear, N., Dodiuk-Gad, R. (eds) Advances in Diagnosis and Management of Cutaneous Adverse Drug Reactions. Adis, Singapore. https://doi.org/10.1007/978-981-13-1489-6_12
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