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Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.

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Background: Hair cortisol concentrations (HCC) +/- DHEA, a depression and stress biomarker has not been studied in severe cutaneous adverse drug reactions (SCAR). Objective: To determine DHEA/HCC correlation with SCAR-associated depression and compare the ratio with published values. Methods: Depres...

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Main Author: Zitha, Eddy
Other Authors: Lehloenya, Rannakoe
Format: Thesis
Language:Eng
Published: Department of Medicine 2025
Subjects:
Dermatology
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access_status_str Open Access
author Zitha, Eddy
author2 Lehloenya, Rannakoe
author_browse Lehloenya, Rannakoe
Zitha, Eddy
author_facet Lehloenya, Rannakoe
Zitha, Eddy
author_sort Zitha, Eddy
collection Thesis
description Background: Hair cortisol concentrations (HCC) +/- DHEA, a depression and stress biomarker has not been studied in severe cutaneous adverse drug reactions (SCAR). Objective: To determine DHEA/HCC correlation with SCAR-associated depression and compare the ratio with published values. Methods: Depression was assessed using M.I.N.I. and DHEA/HCC measured in epidermal necrolysis (EN) and DRESS patients at a South African tertiary hospital. PubMed search was conducted for publications documenting DHEA/HCC. Results: 22/37 participants enrolled were depressed, significantly higher in EN than DRESS. HCC, DHEA or DHEA/HCC were not different between SCAR; depressed versus non-depressed; and presence versus absence of suicidal ideation. DHEA/HCC was unaffected by HIV or TB status. HCC was high in all SCAR patients, regardless of gender. HCC in SCAR was extremely high compared to published healthy controls [309.33 (28.9 - 1835.7) vs. 46.1 (17.7 - 153.2), p = <0.01]; depressed subjects [1349.67 (SD 1935.59) vs. 7.26 (SD 0.47), p = <0.01] and depressed HIV positive males [1479.61 (SD 2313.74) vs. 18.02 (SD 9.37), p =0.0003]. Conclusions: HCC was high and sustained in SCAR irrespective of HIV, TB, or depression status. No association existed between DHEA/HCC ratio and depression. Sustained high cortisol levels potentially impact long-term SCAR-associated outcomes.
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institution University of Cape Town (South Africa)
language Eng
last_indexed 2026-06-10T12:31:35.974Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
publishDateRange 2025
publishDateSort 2025
publisher Department of Medicine
publisherStr Department of Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/41180 Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression. Zitha, Eddy Lehloenya, Rannakoe Khumalo, Nala Peter, Jonny Dermatology Background: Hair cortisol concentrations (HCC) +/- DHEA, a depression and stress biomarker has not been studied in severe cutaneous adverse drug reactions (SCAR). Objective: To determine DHEA/HCC correlation with SCAR-associated depression and compare the ratio with published values. Methods: Depression was assessed using M.I.N.I. and DHEA/HCC measured in epidermal necrolysis (EN) and DRESS patients at a South African tertiary hospital. PubMed search was conducted for publications documenting DHEA/HCC. Results: 22/37 participants enrolled were depressed, significantly higher in EN than DRESS. HCC, DHEA or DHEA/HCC were not different between SCAR; depressed versus non-depressed; and presence versus absence of suicidal ideation. DHEA/HCC was unaffected by HIV or TB status. HCC was high in all SCAR patients, regardless of gender. HCC in SCAR was extremely high compared to published healthy controls [309.33 (28.9 - 1835.7) vs. 46.1 (17.7 - 153.2), p = <0.01]; depressed subjects [1349.67 (SD 1935.59) vs. 7.26 (SD 0.47), p = <0.01] and depressed HIV positive males [1479.61 (SD 2313.74) vs. 18.02 (SD 9.37), p =0.0003]. Conclusions: HCC was high and sustained in SCAR irrespective of HIV, TB, or depression status. No association existed between DHEA/HCC ratio and depression. Sustained high cortisol levels potentially impact long-term SCAR-associated outcomes. 2025-03-14T09:38:30Z 2025-03-14T09:38:30Z 2024 2025-03-14T09:20:58Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41180 Eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Dermatology
Zitha, Eddy
Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.
thesis_degree_str Master's
title Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.
title_full Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.
title_fullStr Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.
title_full_unstemmed Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.
title_short Patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression.
title_sort patients with severe cutaneous adverse drug reactions have extremely high hair cortisol concentrations that do not correlate with presence of depression
topic Dermatology
url http://hdl.handle.net/11427/41180
work_keys_str_mv AT zithaeddy patientswithseverecutaneousadversedrugreactionshaveextremelyhighhaircortisolconcentrationsthatdonotcorrelatewithpresenceofdepression

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