Journal article
Severe Cutaneous Adverse Drug Reactions: Presentation, Risk Factors, and Management.
- Mustafa SS Allergy and Clinical Immunology, Rochester Regional Health System, Rochester, NY, USA. shahzad.mustafa@rochesterregional.org.
- Ostrov D Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
- Yerly D Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland.
- 2018-03-26
Published in:
- Current allergy and asthma reports. - 2018
Acute generalized exanthematous pustulosis (AGEP)
Drug reaction with eosinophilia and systemic symptoms (DRESS)
HLA-associated drug hypersensitivity
Severe cutaneous adverse drug reaction (SCAR)
Stevens-Johnson syndrome (SJS)
Toxic epidermal necrolysis (TEN)
Drug Eruptions
Humans
Risk Factors
English
PURPOSE OF STUDY
Immune-mediated adverse drug reactions occur commonly in clinical practice and include mild, self-limited cutaneous eruptions, IgE-mediated hypersensitivity, and severe cutaneous adverse drug reactions (SCAR). SCARs represent an uncommon but potentially life-threatening form of delayed T cell-mediated reaction. The spectrum of illness ranges from acute generalized exanthematous pustulosis (AGEP) to drug reaction with eosinophilia with systemic symptoms (DRESS), to the most severe form of illness, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
RECENT FINDINGS
There is emerging literature on the efficacy of cyclosporine in decreasing mortality in SJS/TEN. The purpose of our review is to discuss the typical presentations of these conditions, with a special focus on identifying the culprit medication. We review risk factors for developing SCAR, including HLA alleles strongly associated with drug hypersensitivity. We conclude by discussing current strategies for the management of these conditions.
Immune-mediated adverse drug reactions occur commonly in clinical practice and include mild, self-limited cutaneous eruptions, IgE-mediated hypersensitivity, and severe cutaneous adverse drug reactions (SCAR). SCARs represent an uncommon but potentially life-threatening form of delayed T cell-mediated reaction. The spectrum of illness ranges from acute generalized exanthematous pustulosis (AGEP) to drug reaction with eosinophilia with systemic symptoms (DRESS), to the most severe form of illness, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
RECENT FINDINGS
There is emerging literature on the efficacy of cyclosporine in decreasing mortality in SJS/TEN. The purpose of our review is to discuss the typical presentations of these conditions, with a special focus on identifying the culprit medication. We review risk factors for developing SCAR, including HLA alleles strongly associated with drug hypersensitivity. We conclude by discussing current strategies for the management of these conditions.
- Language
-
- English
- Open access status
- closed
- Identifiers
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- DOI 10.1007/s11882-018-0778-6
- PMID 29574562
- Persistent URL
- https://folia.unifr.ch/global/documents/140540
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