Observational study of dermatological manifestations in patients admitted to a tertiary poison center in Iran
Observational study of dermatological manifestations in patients admitted to a tertiary poison center in Iran
Background/aim: Acute unintentional and deliberate poisoning by medications and chemicals is a frequent emergency, especiallyin Iran. This study aimed to evaluate the frequency and character of skin findings occurring in patients with acute intentional andaunintentional poisoning.Materials and methods: This prospective observational study was performed at the Loghman Hakim Hospital Poison Center overa period of 6 months from April 2016 to September 2016. Data including patient demographics, cause of poisoning, and level ofconsciousness were collected. Pediatric patients (under the age of 13) and patients who died in the first hours of admission were excludedfrom the study.Results: The most common cause of toxicity-related admission in our patients was methadone overdose. The most common skinfinding in these patients was xerosis. According to our results, there was an association between tramadol poisoning and self-inducedlesions. Shin hyperpigmentation was found to be significantly more frequent in patients with lead poisoning.Conclusion: Further study is recommended to shed light on the possible association of drug poisoning and skin lesions.
___
- Hassanian-Moghaddam H, Zamani N, Rahimi M, Shadnia S,
Pajoumand A, Sarjami S. Acute adult and adolescent poisoning
in Tehran, Iran; the epidemiologic trend between 2006 and
2011. Arch Iran Med 2014; 17: 534-538.
- Kiadaliri AA, Saadat S, Shahnavazi H, Haghparast-Bidgoli H.
Overall, gender and social inequalities in suicide mortality in
Iran, 2006-2010: a time trend province-level study. BMJ Open
2014; 4: e005227.
- Agrawal P, Peter JV, George R. Dermatological manifestations
and relationship to outcomes of patients admitted to a medical
intensive care unit: a study from a tertiary care hospital in
India. Postgrad Med J 2013; 89: 501-507.
- Reddy K, Lowenstein EJ. Forensics in dermatology: part I. J
Am Acad Dermatol 2011; 64: 801-810.
- Moftah NH, Kamel AM, Attia HM, El-Baz MZ, Abd ElMoty HM. Skin diseases in patients with primary psychiatric
conditions: a hospital based study. J Epidemiol Glob Health
2013; 3: 131-138.
- Tse JY, Adisa M, Goldberg LJ, Nazarian RM. Dermatopathologic
manifestations of intravenous drug use. J Cutan Pathol 2015;
42: 815-823.
- Daly FF, Little M, Murray L. A risk assessment based approach
to the management of acute poisoning. Emerg Med J 2006; 23:
396-399.
- Gordana VE, Zoran Š, Jasmina JS. Benzodiazepine poisoning
in elderly. Vojnosanitetski Pregled 2016; 73: 234-238.
- Beveridge G, Lawson A. Occurrence of bullous lesions in acute
barbiturate intoxication. Brit Med J 1965; 1: 835-837.
- Mandy S, Ackerman AB. Characteristic traumatic skin lesions
in drug-induced coma. JAMA 1970; 213: 253-256.
- Goksu S, Yildirim C, Kocoglu H, Tutak A, Oner U.
Characteristics of acute adult poisoning in Gaziantep, Turkey. J
Toxicol-Clin Toxic 2002; 40: 833-837.
- Haber PS, Elsayed M, Espinoza D, Lintzeris N, Veillard AS,
Hallinan R. Constipation and other common symptoms
reported by women and men in methadone and buprenorphine
maintenance treatment. Drug Alcohol Depend 2017; 181: 132-
139.
- Eizadi-Mood N, Yaraghi A, Sharifian Z, Feizi A, Hedaiaty M,
Sabzghabaee AM. Clinical presentation and the outcome of
therapy in a cohort of patients with methadone toxicity in Iran.
Materia Socio Medica 2015; 27: 276-279.
- Bassiony MM, Youssif UM, Hussein RA, Saeed M. Psychiatric
comorbidity among Egyptian patients with opioid use
disorders attributed to tramadol. J Addict Med 2016; 10: 262-
268.
- Zamani N, Jamshidi F. Abuse of lead-contaminated opium in
addicts. Singapore Med J 2012; 53: 698.
- Karrari P, Mehrpour O, Abdollahi M. A systematic review
on status of lead pollution and toxicity in Iran; guidance for
preventive measures. DARU 2012; 20: 2.
- Khatibi-Moghadam H, Khadem-Rezaiyan M, Afshari R.
Comparison of serum and urine lead levels in opium addicts
with healthy control group. Hum Exp Toxicol 2016; 35: 861-
865.
- Meybodi FA, Eslick GD, Sasani S, Abdolhoseyni M, Sazegar S,
Ebrahimi F. Oral opium: an unusual cause of lead poisoning.
Singapore Med J 2012; 53: 395-397.
- De Caluwe JP. Lead poisoning caused by prolonged use of
kohl, an underestimated cause in French-speaking countries.
J Fr Ophtalmol 2009; 32: 459-463 (in French with abstract in
English).
- Kluger N, Frances P. Bluish pigmentation of the gingiva in a
homeless patient: a quiz. Burton’s line revealing chronic lead
poisoning (plumbism). Acta Derm Venereol 2012; 92: 109-110.
- Mahta A, Kesari S. The greens of lead. QJM-Int J Med 2012;
105: 1223.