Generalized, dusky, erythematous rashes with extensive bullae and skin detachment.This patient presented with acute onset of fever associated with oral mucosa and genital erosions. She developed the above rashes after two days. She was on nifedipine, enalapril, gliclazide, metformin and lovastation for more than a year. Two weeks prior to the onset, she was started on allopurinol for hyperuricaemia.
Many doctors are still so ignorant about the fact that, there is no indication to start allopurinol for asymptomatic hyperuricaemia. Allopurinol is one of the most notorious drugs that can cause Steven Johnson Syndrome and Toxic Epidermal Necrolysis.
In the first place, there should not be a routine to do blood uric acid level, unless clinically indicated. It is sad that many GPs as well as private laboratories performing routine blood tests fail to understand such principle.
Many doctors are still so ignorant about the fact that, there is no indication to start allopurinol for asymptomatic hyperuricaemia. Allopurinol is one of the most notorious drugs that can cause Steven Johnson Syndrome and Toxic Epidermal Necrolysis.
In the first place, there should not be a routine to do blood uric acid level, unless clinically indicated. It is sad that many GPs as well as private laboratories performing routine blood tests fail to understand such principle.
2 comments:
Hi. Well, in the private sector, the patients want the uric acid tests or any other blood tests. And we doctors make money from it. So we just do it lah.
Sincerely, your money-faced friend, Chen.
It is fine if patients insist on the blood test since they pay for it, but the result should be interpreted with care and treatment instituted accordingly (if it is indicated).
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