Which intercurrent infections are associated with maculopapular cutaneous drug reactions? A case-control study

Background: Patients with lymphotrophic viral infections are at increased risk for cutaneous drug reactions (CDRs). However, the association between other intercurrent infections and maculopapular CDRs has not been evaluated by epidemiologic methods. Objective: We conducted a case-control study in order to evaluate the exposure to intercurrent infections in patients with maculopapular CDRs. Methods: Data were obtained through assessment of files of 53 patients hospitalized for maculopapular CDRs in the Department of Dermatology and 159 control patients. Exposure to intercurrent infections was recorded in patients and controls. Results: An intercurrent infectious disease was documented in 31/53 (58.5%) of patients with CDRs, as compared to 12/159 (7.5%) patients in the control group (OR 17.26, 95% CI: 7.24-42.00). Maculopapular CDRs were associated with respiratory tract infections (OR 20.53, 95% CI: 5.20-94.45), and urinary tract infections (OR 20.61, 95% CI: 2.36-465.99), but not with skin infections (OR 3.83, 95% CI: 0.85-17.87) or other infections. Conclusions: Our study implies that maculopapular CDRs are associated with respiratory tract infections as well as urinary tract infections. Further study is needed to evaluate the role of intercurrent infections in the pathogenesis of CDRs.