Correlations between epithelial cells and bacterial populations in bacteriological skin samples

The purposes of this study were to determine whether the variability in populations of skin bacteria observed between individuals is related to the number of epithelial cells removed during the skin scrubbing procedure and also whether any particular group of microorganisms can be directly associated with epithelial cells. Foreheads of 31 subjects were sampled using the cup scrubbing method, and bacterial populations were quantified as: total anaerobes, aerobes, Propionibacterium spp., aerobic coryneforms, and Micrococcaceae. Epithelial cells were counted in a haemocytometer. Correlation coefficients were positive between total bacterial populations and epithelial cell counts, with the largest values of 0.64 for Propionibacterium spp., 0.58 for Micrococcaceae, and 0.15 for aerobic coryneforms. High epithelial cell counts were always associated with high bacterial populations, but high bacterial counts occurred, in some instances, with low epithehal cell counts; epithelial cells are not, therefore, responsible for variations in bacterial populations in all cases. Stained smears of epithelial cells from subjects from whom aerobic coryneforms were not cultured showed microcolonies of presumptive anaerobic diphtheroids, closely associated with epithelial cells. These findings and the high correlation between Propionibacterium spp. and epithelial cells suggests a re-examination of the location of anaerobes in the stratum corneum.     

Bacteriological study of epidermal cysts

The aim of this study was to determine whether bacterial infection plays a significant role in the inflammatory process of epidermal cysts. Samples from 152 patients (115 cases of inflamed and 37 of uninflamed epidermal cysts) were subjected to aerobic and anaerobic bacterial culture and the isolates were investigated. The rate of bacterial growth and the recovered anaerobes were significantly greater in the inflamed than the uninflamed epidermal cysts. However, it is difficult to determine whether recovered isolates from epidermal cysts represent "infection" or "colonization". In conclusion, this study revealed the predominance of anaerobes in inflamed cysts, strongly suggesting that anaerobes play a role in the inflammatory process.     

Microbiology of infected epidermal cysts

Specimens from 231 epidermal cyst abscesses were inoculated on media supportive for growth of aerobic and anaerobic bacteria. Of these, 192 yielded bacterial growth. Aerobic or facultative bacteria only were recovered in 84 specimens (44%), anaerobic bacteria only in 57 specimens (30%), and mixed aerobic and anaerobic bacteria in 51 specimens (26%). A total of 315 isolates (162 anaerobes and 153 aerobes) were recovered. An average of 0.8 aerobic or facultative isolates per infected cyst were recovered, and this number was unrelated to the cysts' anatomic sites. However, the number of anaerobic bacteria varied; they were isolated more frequently in perirectal (1.5 isolates per specimen), vulvovaginal (1.4), and head (1.1) infections, and less frequently in trunk (0.7) and extremities (0.4) infections. The predominant aerobic or facultative bacteria were Staphylococcus aureus (81 isolates), group A streptococcus (9 isolates), and Escherichia coli (7 isolates). The predominant anaerobic organisms were Peptostreptococcus species (85 isolates) and Bacteroides species (55 isolates, including 12 Bacteroides melaninogenicus and 9 Bacteroides fragilis groups). The study highlights the polymicrobial nature and predominance of anaerobes in cyst abscesses in the perirectal, vulvovaginal, and head areas.     

Aerobic and anaerobic microbiology of chronic venous ulcers

Abstract
Background The role of bacteria in the pathogenesis of chronic venous leg ulcers (CVLU) is unclear. The objective of the study was to establish the aerobic and anaerobic bacteriology of CVLU.
Methods A retrospective review was carried out of the clinical and microbiological laboratory records obtained from patients with CVLU. Microorganisms were grown from 43 specimens obtained from 41 patients.
Results Aerobic or facultative bacteria alone were present in 18 (42%) specimens, anaerobic bacteria only in three (7%), and mixed aerobic–anaerobic flora in 22 (51%).
In total, there were 97 isolates, 64 aerobic or facultative and 33 anaerobic, an average of 2.3 isolates per specimen (1.5 aerobes and 0.8 anaerobes). The predominant aerobic organisms were Staphylococcus aureus (26 isolates), group D streptococci (5), and Escherichia coli (5). The predominant anaerobes were Peptostreptococcus spp. (15), Bacteroides fragilis group (6), Propionibacterium acnes (4), and Prevotella spp. (3).
Conclusions CVLU have a polymicrobial aerobic–anaerobic flora.     

Microbiology of perianal cellulitis in children: comparison of skin swabs and needle aspiration

Objective To establish the aerobic and anaerobic microbiology of perianal cellulitis in children, comparing skin swab and needle aspirate methodology. Method Swabs of involved skin and needle aspirates of cellulitis were studied for aerobic and anaerobic bacteria. Results Specimens obtained from 10 patients with perianal cellulitis showed bacterial growth. Polymicrobial aerobic–anaerobic flora was found in all skin surface cultures, where the predominate isolates were Peptostreptococcus spp., Escherichia coli, and alpha hemolytic streptococci. The number of isolates in needle aspirates varied between one and two. The predominant ones were E.coli (3), Peptostreptococcus spp. (3), Staphylococcus aureus (2), and Bacteroides fragilis group (2). Complete or partial concordance in microbiology between skin swabs and needle aspirates was present in six instances. In four instances, isolates recovered from needle aspirates were not isolated from the skin surface. Conclusions This study demonstrates the diversity of aerobic and anaerobic organisms isolated from perianal cellulitis, and the superiority of needle aspirates in establishing the microbiology of the infection.     

Anaerobes in men with urethritis

Sixty-four men with non-gonococcal urethritis (NGU), seven with gonococcal urethritis (GU), and 30 who had no symptoms or signs of urethritis were studied. Chlamydia trachomatis was isolated from urethral specimens taken from 22% of the men with NGU, and 18% with GU, but not from those who did not have urethritis even though 20 (67%) of them had a history of NGU, GU, or both. The chlamydial isolation rate for men having NGU for the first time was 30%. Ureaplasma urealyticum was isolated from 42% of the men with NGU, 43% of men with GU, and 27% of those without urethritis.

In addition to aerobes anaerobes were isolated frequently from men whether or not they had urethritis, the most common being anaerobic Corynebacteria, peptococci, and micro-organisms of the Bacteroides-Fusobacteria group. There was no appreciable difference in the overall isolation of anaerobes from men with NGU (89%) or from those without disease (80%). The rate of isolation of a Gram-negative anaerobic bacillus from men with NGU (50%) was, however, strikingly different to that from men with GU (14%) or from those without disease (13%). Furthermore, this bacillus was recovered from 28 (56%) of 50 men with NGU who were considered chlamydia-negative and from 19 (61%) of 31 men who were both chlamydia-negative and ureaplasma-negative. The effect of antibiotic treatment was evaluated in a few patients only, so that although those from whom the Gram-negative bacillus was eliminated by tetracycline recovered clinically there is a need for a prospective therapeutic trial to evaluate further the importance of the bacillus.

     

MICROBIOLOGY OF INFECTED ATOPIC DERMATITIS

Background. Bacterial infections occur frequently in lesions of atopic dermatitis (AD). The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD. Methods. A retrospective review was carried out of clinical and microbiology laboratory records and of data obtained from patients with secondarily infected AD lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. Results. Bacterial growth was noted in 41 specimens. Aerobic or facultative anaerobic bacteria only were present in 15 patients (36%), anaerobic bacteria only in eight (20%), and mixed anaerobic-aerobic flora was present in 18 (44%). Seventy- two isolates were recovered (1.8 per specimen), 34 aerobic or facultative bacteria, 35 strict anaerobes, and three Candida sp. The predominant aerobic and facultative bacteria were Staphylococcus aureus (12 isolates). Group A beta hemolytic streptococcus in five isolates, and Escherichia coli in four. The predominant anaerobes were peptostreptococcus spp. (13 isolates), pigmented Prevotella and Porphyromonas spp. in eight, and Fusobacterium spp. in four isolates. Single bacterial isolates were recovered in 14 patients (34%), seven of which were S. aureus. Twenty-one of the organisms isolated from 16 patients (39%) produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric gram-negative rods and bacteroides fragilis group predominated in lesions on legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Porphyromonas and Fusobacterium spp. were most frequently recovered in lesions of the finger, scalp, face, and neck. Conclusions. The polymicrobial etiology of secondarily infected AD lesions and the association of bacterial flora with the anatomic site of the lesions are demonstrated.     

Aerobic and anaerobic bacterial flora of crural ulcers

In a group of 600 patients treated in the Metropolitan Dermatological Hospital in Warsaw bacteriological examination were carried out of swabs from the untreated crural ulcers. In 95% of these cultures growth of pathological aerobic organisms was obtained. Coagulase-positive staphylococci (St. aureus) and Gram-negative bacteria (Pseudomonas aeruginosa, Proteus vulgaris, Enterobacter sp and E. coli) prevailed. In 27% of cases the cultured strains were resistant to the generally available antibiotics. In the second group in 70 patients no growth of anaerobes exclusively was noted. Pathological aerobes and anaerobes in the same case were found in 45% of cultures. In the remaining ones pathogenic aerobes were present with a similar frequency as in the preceding group. Of the anaerobes the most frequently cultured species were Gram-negative bacteria such as Bacteroides melaninogenicus, Bacteroides sp, and Bacteroides fragilis. Among pathogenic anerobic cocci Peptostreptococcus and Peptococcus were most frequent. In 2 cases spore-forming anaerobic bacteria (Clostridium perfringens) were obtained. Forty-eight percent of anaerobes were resistant to the commonly used antibiotics.     

The infectious aetiology of tropical ulcer—a study of the role of anaerobic bacteria

We have cultured anaerobic bacteria from patients with tropical ulcers. Fusobacteria were isolated most frequently. Anaerobes were always present, together with aerobes or facultative anaerobes, particularly in early phase ulcers, suggesting that the combination of organisms is important in the pathogenesis of the disease. Spirochaetes were identified in material examined by light and electron microscopy, but were not cultured.     

Microbiology of infected hemangiomas in children

Bacterial infections are a common complication of hemangiomas in children. The objective of this study was to establish the aerobic and anaerobic microbiology of infected hemangiomas. A retrospective 8-year review of clinical and microbiology laboratory records from patients with secondarily infected hemangiomas was carried out. Specimens from infected sites were processed for the presence of aerobic and anaerobic bacteria. Bacterial growth was present in 32 of 38 specimens. Aerobic bacteria alone were recovered in 12 infected hemangiomas (37.5%), anaerobic bacteria alone in 8 (33%), and mixed aerobic and anaerobic flora in 12 (37.5%). A total of 80 isolates (47 aerobes and 33 anaerobes) were recovered, giving an average of 2.5 isolates per specimen (1.5 aerobes and 1.0 anaerobes). The highest number of isolates were recovered in infections of the perineum (3.7 per site) and the legs (2.8 per site). The predominant aerobic isolates were Staphylococcus aureus, group A beta-hemolytic streptococci, and Enterobacteriaceae. The predominant anaerobes were Peptostreptococcus sp., gram-negative bacilli, and Fusobacterium sp. Organisms that belong to the mucous membranes close to the lesions predominated in infections next to those membranes. The polymicrobial etiology of secondarily infected hemangiomas and the association of bacterial flora with the anatomic site of the lesions is thereby demonstrated.     

Microbiology of infected poison ivy dermatitis

We report the aerobic and anaerobic microbiology of secondarily infected poison ivy dermatitis. The study involved retrospective review of clinical and microbiology laboratory records of patients with secondarily infected poison ivy lesions. Bacterial growth was noted in 33 specimens. Aerobic or facultative anaerobic bacteria only were present in 18 (55%) patients, anaerobic bacteria only in seven (21%), and mixed anaerobic-aerobic bacteria in eight (24%). Forty-five isolates were recovered (1.4 per specimen): 27 aerobic or facultative anaerobic bacteria, and 18 strict anaerobes. The predominant aerobic and facultative anaerobic bacteria were Staphylococcus aureus (13 isolates) and group A beta-haemolytic streptococci (six). The predominant anaerobes were Peptostreptococcus spp. (seven isolates), pigmented Prevotella and Porphyromonas spp. (four) and Fusobacterium spp. (two). Single bacterial isolates were recovered in 18 (55%) patients, eight of which were S. aureus. Nineteen of the organisms isolated from 16 (48%) patients produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in those infections. Enteric gram-negative rods and Bacteroides fragilis group predominated in leg and buttock lesions. Group A beta-haemolytic streptococci, pigmented Prevotella and Porphyromonas and Fusobacterium spp. were most frequently recovered from lesions of the finger, face and neck. The polymicrobial aetiology of secondarily infected poison ivy lesions, and the association of bacterial flora with the anatomical site of the lesions, are demonstrated.     

The microbiology of infected and noninfected leg ulcers

BACKGROUND: A clinical study was undertaken to investigate and compare specifically the aerobic and anaerobic microbiology of infected and noninfected leg ulcers. METHODS: Leg ulcers, defined as being infected on the basis of clinical signs, were swab sampled and investigated for aerobic and anaerobic microorganisms using stringent isolation and identification techniques. RESULTS: Two hundred and twenty isolates were cultured from 44 infected leg ulcers, in comparison with 110 isolates from 30 noninfected leg ulcers. Statistical analysis indicated a significantly greater mean number of anaerobic bacteria per infected ulcer (particularly Peptostreptococcus spp. and Prevotella spp.) in comparison with the noninfected ulcer group (2.5 vs. 1.3, respectively) (P < 0.05). Also, anaerobes represented 49% of the total microbial composition in infected leg ulcers compared with 36% in noninfected leg ulcers. The mean numbers of aerobes per wound in the two ulcer groups were not statistically different (P > 0.05). The study failed to demonstrate a clear correlation between commonly implicated facultative pathogens and wound infection. The isolation rate of Pseudomonas aeruginosa was generally low and, although Staphylococcus aureus was a frequent isolate in both wound types, it was more prevalent in noninfected leg ulcers. CONCLUSIONS: This study has demonstrated the complex aerobic-anaerobic microflora which exists in leg ulcers, the prevalence of anaerobes in infected wounds, and a poor correlation between the presence of specific aerobic pathogens and wound infection. In view of these findings, the role of microbial synergistic interactions in the pathogenesis of chronic wound infection may be of greater clinical importance than the isolated involvement of any specific potential pathogen.     

Microbiology of infected pustular psoriasis lesions

BACKGROUND: Bacterial infections can occur in lesions of pustular psoriasis (PP). The objective of this study was to establish the aerobic and anaerobic microbiology of secondarily infected PP. METHODS: A retrospective 10-year review was carried out of clinical and microbiology laboratory records from patients with secondarily infected PP lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. RESULTS: Bacterial growth was noted in 23 specimens. Aerobic or facultative anaerobic bacteria only were present in 12 patients (52%), anaerobic bacteria only in four (17%), and mixed anaerobic-aerobic flora was present in seven (30%). Thirty-six isolates were recovered (1.6 per specimen), 23 aerobic or facultative bacteria and 13 strict anaerobes. The predominant aerobic and facultative bacteria were Staphylococcus aureus (15 isolates), Group D Enterococcus (two isolates), and Escherichia coli (two isolates). The predominant anaerobes were Peptostreptococcus spp. (six isolates) and Bacteroides fragilis group, Propionibacterium acnes, and pigmented Prevotella spp. in two each. Single bacterial isolates were recovered in 14 patients (61%), 11 of which were S. aureus. Nineteen of the organisms isolated from 18 patients (78%) produced the enzyme beta-lactamase. S. aureus was isolated from all body sites. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric Gram-negative rods and Bacteroides fragilis group predominated in lesions on the legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Fusobacterium spp. were most frequently recovered in lesions of the hand. CONCLUSIONS: The polymicrobial etiology of secondarily infected PP lesions and the association of bacterial flora with the anatomic site of the lesions were demonstrated.     

Microorganisms inhabiting follicular contents of facial acne are not only Propionibacterium but also Malassezia spp.

To clarify the relationship between major cutaneous microorganisms (Propionibacterium, Staphylococcus and Malassezia spp.) and acne vulgaris (acne), we examined the microbiota quantitatively in the follicular contents of inflammatory acne and on the facial skin of patients with acne. Fifteen Japanese untreated acne outpatients were studied. The follicular contents from inflammatory acne lesions of the face were collected using a comedo extractor. The skin surface samples were obtained by the swab method from 10 cm² of facial skin. The microbiota was analyzed using polymerase chain reaction. The microbiota in follicular contents was similar to that on the skin surface, namely, there were large populations of Propionibacterium spp., Staphylococcus spp. and Malassezia spp. Moreover, the number of Malassezia spp. on the skin surface was correlated with that of inflammatory acne and that in follicular contents. This study clarified that there are large populations of Propionibacterium spp., Staphylococcus spp. and Malassezia spp. in follicular contents. These results suggest the possibility that not only Propionibacterium acnes but also other cutaneous resident microorganisms are related to acne. Particularly, we considered that Malassezia spp. is closely related.     

Comparative Analysis of Cutaneous Fungi in Atopic Dermatitis Patients and Healthy Individuals

BackgroundAtopic dermatitis (AD) is a chronic relapsing inflammatory skin disease triggered by diverse factors. Microbes are one of the crucial risk factors for AD development or exacerbation. However, the effect of a fungal burden on AD has been overlooked compared to bacteria.ObjectiveThis study aimed to comparatively analyze cutaneous fungal distribution between AD patients and healthy individuals by polymerase chain reaction (PCR)-based analysis.MethodsSkin samples of AD outpatients and healthy individuals collected at the Chung-Ang University were analyzed. Representative AD-associated fungal genera, Candida, dermatophytes, and Malassezia , were analyzed using specific primer and amplification methods. Amplicons were sequenced, and the fungal distribution of both groups were compared.ResultsTotally, 211 patients and 23 healthy individuals were studied. Of the 211 patients, 10.90% (23/211) had Candida species, whereas 0% (0/23) healthy individuals showed its presence. The most frequently detected species in patients was Candida albicans (5.21%) followed by Candida parapsilosis (3.79%). For dermatophytes, 1.42% (3/211) of patients showed positive results, whereas 0% (0/23) healthy individuals showed positive results. Malassezia species were identified in 20.85% (44/211) and 8.70% (2/23) in patients and healthy individuals, respectively. Malassezia restricta was the most frequently identified species in the AD patient group, and the only species found in the healthy control group.ConclusionThe distribution of Candida spp., dermatophytes, and Malassezia spp. are altered with AD development.     

Microbiology of Nonbullous Impetigo

Abstract: Our objective was to establish the aerobic and anaerobic microbiology of nonbullous impetigo (Nl) in children. We used a retrospective review of clinical microbiology laboratory and patients'records. Specimens were obtained from 40 patients with Nl lesions and showed bacteriai growth. Aerobic or facultative anaerobic bacteria only were present in 24 patients (60%), strict anaerobic bacteria only in 5 patients (12.5%), and mixed anaerobic-aerobic flora was present in 11 patients (27.5%). Sixty-four isolates were recovered (1.6 per specimen): 43 aerobic or facultative, and 21 anaerobic. The predominant aerobic and facultative bacteria were Staphylococcus aureus (29 isolates). Group A beta hemolytic streptococcus (GABHS) (13 Isolates), and Escherichia coli (1 isolate). The predominant anaerobes were Peptostreptococcus spp. (12), pigmented Prevotella spp. (5), Fusobacterium spp. (2), and Bacteroides fragilis (1). Single bacterial isolates were recovered in 17 patients (42.5%), 13 of which were S. aureus. S. aureus alone or mixed with GABHS or Peptostreptococcus spp. were isolated from all body sites. Mixed flora of Peptostreptococcus spp. with Prevotella spp. or Fusobacterium spp. was mostly found in infections of the head and neck, while E. coli mixed with B. fragills and Peptostreptococcus spp. were isolated from one infection of the buttocks area. Thirty-three organisms isolated from 32 patients (80%) produced the enzyme beta-lactamase. This study demonstrates the polymicrobial aerobic-anaerobic microbiology of Nl lesions.     

Comparison of a hydrocolloid dressing and paraffin gauze in the treatment of venous ulcers

In-patients with venous leg ulcers showed increased healing rates with a hydrocolloid dressing (Granuflex), as compared with a traditional paraffin gauze dressing (Jelonet), in a randomized sequential crossover trial, although the difference was not statistically significant. Bacteriological studies showed that the hydrocolloid dressing favoured growth of both aerobes and anaerobes in significantly greater numbers compared with paraffin gauze. Heavy bacterial colonization had no effect on the healing rates of the ulcers. Granuflex is said to produce an anaerobic environment--survival of Pseudomonas aeruginosa, a strict aerobe, under Granuflex dressings, makes this seem unlikely.     

Skin areas,clinical severity,duration and risk factors of intertrigo: A secondary data analysis

AimTo describe the skin areas most often affected by intertrigo, the clinical severity and duration of intertrigo and possible risk factors.Materials and methodsSecondary analysis of data from 2013 to 2016 collected by the International Prevalence Measurement of Care Quality in Dutch hospitals, care homes and community care.ResultsIn total, n = 7865 (mean age 80.1 years) subjects were included in this analysis. The inguinal, breast and gluteal cleft skin areas were most often affected by intertrigo. The skin was often inflamed but not eroded. Strongest associations between intertrigo at inguinal skin and diabetes mellitus (OR 1.8; 95% CI 1.1–3.1), intertrigo at sub mammary folds and urinary incontinence (OR 1.6; 95% CI 0.9–2.9) and between intertrigo at gluteal cleft and urinary incontinence (OR 2.9; 95% CI 1.4–5.2) were observed.ConclusionThe inguinal region, sub mammary folds and gluteal clefts are most often affected by intertrigo. Female sex, urinary incontinence and high BMI seem to enhance intertrigo risk at all of these skin areas.     

Fixed-drug eruption: A retrospective study in a single referral center in northern Taiwan

Background/ObjectiveFixed drug eruption (FDE) is a dermatosis characterized by recurrent patches or plaques at exactly the same sites with each administration of the causative drug. Vesicles or bullae may sometimes be found, and generalized bullous fixed drug eruption (GBFDE) may be confused with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). This study aimed to investigate the clinical and pathologic features of FDE in Taiwan.MethodsA retrospective analysis evaluated patients with FDE in a referral center in Taiwan covering a period of 11 years. Clinical data, suspected etiologies, and pathology/patch test results were collected. We also compared the GBFDE cases with SJS/TEN overlap or TEN cases to find differentiating clues.ResultsThere were 39 FDE patients, including nine GBFDE cases. The most frequent causative drugs were non-steroidal anti-inflammatory drugs (five cases, 12.8%) and antibiotics (four cases, 10.3%). Extremities other than the hands (71.8%) were the most frequently affected sites, followed by the trunk (51.3%), mucosa (38.5%), and hands (33.3%). The average age of FDE patients was 52.2 years (median, 56 years; range, 4–86 years). Patients with GBFDE were significantly older than non-GBFDE patients (69.1 ± 19.7 vs. 47.2 ± 23.6, p = 0.0124) and the trunk was more likely to be involved in GBFDE cases (88.9% vs. 40.0%, p = 0.0197). GBFDE cases also showed tendency to have more mucosal involvement (66.7% vs. 30.0%, p = 0.0631). Although similar to SJS/TEN, GBFDE cases had fewer constitutional symptoms, less mucosal involvement but had previous episodes. Histopathologically, the presence of more than two aggregated dyskeratotic keratinocytes (fire flag sign) in the epidermis was more frequently observed in SJS/TEN, whereas GBFDE had superficial and deep dermal infiltration of eosinophils and melanophages.ConclusionFDE is one of the specialized cutaneous drug reactions and GBFDE should be kept in mind and differentiated from SJS/TEN.     

Severe Cutaneous Adverse Reactions: A Single-Center Retrospective Study of 173 Patients in China

BackgroundSevere cutaneous adverse reactions (SCAR) to drugs are a crucial public health issue and the use of systemic corticosteroids in SCAR has been controversial.ObjectiveTo analyze clinical features, causative drugs, treatment, outcomes, and prognostic factors of SCAR in the case-series of 173 patients, and add more information to the debate of using systemic corticosteroids in SCAR management.MethodsA retrospective study of 173 SCAR patients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) or acute generalized exanthematous pustulosis (AGEP) at a tertiary care institution in China between January 2014 and December 2017 was conducted.ResultsOf 173 patients, allopurinol, carbamazepine, and antibiotics are the most frequently implicated drugs for DRESS (40.4%), SJS/TEN (26.0%), and AGEP (40.0%) respectively. Moreover, there is a strongly negative correlation between early corticosteroids use and the progression (p=0.000) and severity (p=0.01) of skin lesions. However, there is no association between early corticosteroids use and the mortality of SCAR (odds ratio: 1.01, 95% confidence interval: 0.95~1.08). In addition, lymphadenopathy, eosinophilia, and interval from onset to corticosteroids treatment were correlated with SCAR prognosis.ConclusionPrompt short-course systemic corticosteroids use is associated with early-stage skin lesions remission without influencing the disease mortality. Lymphadenopathy and eosinophilia were the independent poor prognostic factors of SCAR.