AIM: The study sought to identify the magnitude and characteristic of severe 
cutaneous adverse reactions (SCAR's) like Steven-Johnson syndrome (SJS) and 
Toxic Epidermal Necrolysis (TEN).
MATERIALS AND METHODS: A prospective study was conducted by the Department of 
Pharmacology in association with Department of Dermatology in SMHS hospital. The 
study was carried out from June 2013-June 2015 on hospitalized cases of 
cutaneous adverse drug reaction reporting in hospital. The SCAR's were reported 
in a structured questionnaire based on adverse drug reaction (ADR) reporting 
form provided by the Central Drug Standard Control Organization (CDSCO) Ministry 
of Health and Family welfare, Government of India. The SCAR's were analysed for 
their characteristics, causality, severity and prognosis. Causality assessment 
was done by using a validated ADR probability scale of Naranjo as well as WHO 
Uppsala Monitoring Center (WHO-UMC) system for standardized case causality 
assessment. The management protocol were analysed for their clinical outcome 
through a proper follow up period.
RESULTS: A total of 52 hospitalized cases of cutaneous adverse drug reactions 
were reported during the study period. We identified a total of 15 cases (28%) 
of SCAR's involving 9(17%) of SJS and 6 (12%) of TEN. SJS was seen in 2(22%) 
males and 7(78%) females. TEN was seen in all females (100%) and in no male. 
Drugs implicated in causing these life threatening reactions were identified as 
anticonvulsant agents like carbamazepine (CBZ), phenytoin (PHT) and Lamotrigine 
(LTG), oxicam NSAID, Sulfasalazine and levofloxacin. Despite higher reported 
mortality rates in SJS and TEN all patients survived with 2 patients surviving 
TEN suffered from long term opthalmological sequelae of the disease.
CONCLUSION: Present study suggest that drug induced cutaneous eruptions are 
common ranging from common nuisance rashes to rare life threatening diseases 
like SJS and TEN, SJS/TEN typically occur 1-3 weeks after initiation of therapy. 
Aromatic AED's, LTG, oxicam NSAID's, sulfasalazine and levofloxacin have a 
tremendous potential to trigger SCARS's. To ensure safe use of pharmaceutical 
agents and better treatment outcomes post marketing voluntary reporting of 
severe rare and unusual reactions remains inevitable.