BACKGROUND: Severe cutaneous adverse reactions (SCAR) are rare but important 
causes of morbidity and mortality. Stevens-Johnson syndrome (SJS), Toxic 
Epidermal Necrolysis (TEN), and drug reaction with eosinophilia and systemic 
symptoms (DRESS) are severe cutaneous drug reactions that can be potentially 
life threatening. Our study aims to look at the epidemiology of SCAR in the 
local setting in Singapore and the underlying characteristics of our patients 
that may influence the drug reaction seen.
METHODS: Data was collected retrospectively from in-patient records in the 
period of January 2007 to December 2011. We looked at several factors: (i) 
patient demographics including age, gender, ethnicity, comorbidities, (ii) 
culprit drug(s), (iii) latent period, (iv) drug reaction observed, (v) systemic 
complications, (vi) length of hospital stay, (vii) treatment given, and (viii) 
outcomes (mortality, morbidity).
RESULTS: We collected data from 42 patients. The mean age of our patients was 
51.8 years. Twenty-nine (69%) of the patients had underlying comorbidities. The 
most common culprit drug group was antibiotics. SJS was the most common SCAR 
observed (54.8%), followed by acute generalized exanthematous pustolosis (AGEP; 
24%), TEN (11.9%), and DRESS (2%). Sixteen patients (38.1%) had complications, 
and there was one reported death. There was a weak correlation (correlation 
coefficient 0.29, P value = 0.15, 95% CI = 2.07) between early steroid therapy 
and the length of stay.
CONCLUSIONS: Antibiotics are the most common culprit drugs. The most common SCAR 
observed in our study was SJS. Early initiation of steroids may lead to a more 
favorable outcome.