Review
Biochemistry & Molecular Biology
Fumi Miyagawa, Hideo Asada
Summary: For severe cutaneous adverse reactions (SCARs) like Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and drug-induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and systemic symptoms (DRESS), analyzing distinct chemokine profiles can aid in their diagnosis and treatment. It is crucial to identify new therapeutic targets for SCARs, with chemokines playing a key role in the pathogenesis and adjuvant diagnosis of these conditions. Additionally, the association between human herpesvirus 6 (HHV-6) and DIHS/DRESS, as well as the possible roles of chemokine/chemokine receptor homologs encoded by HHV-6 in the pathogenesis, are areas of increasing interest.
Review
Pharmacology & Pharmacy
Blanca R. Del Pozzo-Magana, Carmen Liy-Wong
Summary: Drug-induced skin disease or cutaneous adverse drug reactions (CADRs) refer to the clinical manifestations of the skin, mucosae, and adnexa caused by a drug or its metabolites. The majority of CADRs are mild and self-resolving, but some can be life-threatening. CADRs can mimic various dermatoses, and there are different types and morphologies of CADRs. Antibiotics, nonsteroidal anti-inflammatory drugs, and antiepileptics are the most commonly implicated drugs.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Public, Environmental & Occupational Health
Quentin Beytout, Nagisa Godefroy, Gentiane Monsel, Stephane Jaureguiberry, Eric Caumes
Summary: The prevalence of anti-tuberculosis related adverse cutaneous reactions is around 1%. The most frequent reactions are exanthema, followed by urticaria and drug rash with eosinophilia and systemic symptoms (DRESS). Sequential drug reintroduction can quickly identify the main culprit drug and achieve good outcomes. Rifampicin and pyrazinamide are the two most common culprit drugs, while ethambutol and rifampicin are associated with DRESS.
JOURNAL OF TRAVEL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Yi-Shin Huang, Chen-Yi Wu, Ting-Tsung Chang, Cheng-Yuan Peng, Gin-Ho Lo, Chao-Wei Hsu, Chi-Tan Hu, Yi-Hsiang Huang
Summary: DILI patients combined with SCAR are common and have a high mortality rate in Taiwan. Allopurinol is the main culprit drug. Jaundice, acute kidney injury, and SJS/TEN are independent risk factors for mortality. HLA-B*5801, chronic kidney disease, and high drug dosage also contribute to the high mortality in cases of allopurinol-induced DILI with SCAR.
LIVER INTERNATIONAL
(2021)
Article
Veterinary Sciences
Migyeong Geum, Hui-Yeon Ko, Yeon-Joo Na, Ha-Jung Kim
Summary: A 9-year-old intact female toy poodle developed a possible cutaneous adverse drug reaction to firocoxib, characterized by neck edema and cutaneous necrosis after initiation of firocoxib treatment and placement of a cervical collar for intervertebral disc disease. Discontinuation of firocoxib treatment and initiation of immunosuppressive therapy led to significant improvement in skin lesions, with the dog fully recovering in 7 weeks.
VETERINARY MEDICINE AND SCIENCE
(2021)
Article
Emergency Medicine
Zerrin Defne Dundar, Munise Daye
Summary: The study showed that neutrophil-to-lymphocyte ratio (NLR) is a valuable prognostic parameter for emergency department (ED) patients with cutaneous adverse drug reactions, helping to identify severe patients early on. NLR can be used as an indicator of systemic inflammatory involvement and to determine which patients in this group will require hospitalization.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Dermatology
Hossein Mortazavi, Anahita Rostami, Alireza Firooz, Nafiseh Esmaili, Maryam Ghiasi, Vahideh Lajevardi, Ali Akbar Amirzargar, Iman Sheykhi, Ali Khamesipour, Marwa Akhdar
Summary: This study evaluated the association between benign and severe cutaneous adverse drug reactions (CADRs) and HLA alleles in Iranian patients. The results showed significant correlations between certain HLA alleles and CADRs caused by specific drugs.
DERMATOLOGIC THERAPY
(2022)
Article
Allergy
Kye Hwa Lee, Dong Yoon Kang, Hyun Hwa Kim, Yi Jun Kim, Hyo Jung Kim, Ju Han Kim, Eun Young Song, James Yun, Hye-Ryun Kang
Summary: By analyzing pre-stored HLA information of transplant patients, the study found that individuals with high-risk HLA genotypes were more likely to experience type B adverse drug reactions (ADRs) when using certain medications. Utilization of pre-stored HLA data can prevent type B ADRs, including severe cutaneous adverse reactions (SCARs).
CLINICAL AND TRANSLATIONAL ALLERGY
(2022)
Review
Medicine, General & Internal
Shang-Chen Yang, Chun-Bing Chen, Mao-Ying Lin, Zhi-Yang Zhang, Xiao-Yan Jia, Ming Huang, Ya-Fen Zou, Wen-Hung Chung
Summary: In recent years, significant progress has been made in the research of SCARs, including SJS/TEN, particularly in the genetic factors. The identification of genetic alleles associated with drugs related SCARs has been an important breakthrough for the prevention of these severe skin reactions.
FRONTIERS IN MEDICINE
(2021)
Review
Medicine, General & Internal
Francesco Bellinato, Martina Maurelli, Paolo Gisondi, Giampiero Girolomoni
Summary: This review summarizes the cutaneous adverse reactions associated with SARS-CoV-2 vaccines, categorizing them into new onset reactions and flares of preexisting dermatoses. Injection site reactions are the most common, affecting 30-70% of cases and generally mild or moderate.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Dermatology
Thomas K. Le, Subuhi Kaul, Laura C. Cappelli, Jarushka Naidoo, Yevgeniy R. Semenov, Shawn G. Kwatra
Summary: A cross-sectional study revealed that patients receiving anti-PD-1 ICI therapy had a higher incidence of non-cancerous dermatoses, including mucositis, xerostomia, pruritus, and lichen planus/lichenoid dermatitis.
JOURNAL OF DERMATOLOGICAL TREATMENT
(2022)
Review
Health Care Sciences & Services
Ali Fadhel Ahmed, Chonlaphat Sukasem, Majeed Arsheed Sabbah, Nur Fadhlina Musa, Dzul Azri Mohamed Noor, Nur Aizati Athirah Daud
Summary: This review highlights the immune mechanisms and genetic risk factors involved in severe cutaneous adverse reactions caused by antiepileptic drugs, emphasizing the importance of pharmacogenetic markers in predicting and preventing such reactions.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Review
Behavioral Sciences
Christian Brandt, Lynanne McGuire, Jack Uetrecht
Summary: Severe cutaneous adverse reactions (SCARs) can be life-threatening with significant morbidity and mortality. Awareness of SCAR among clinicians treating patients with antiseizure medications (ASMs) is crucial for early recognition, removal of causal drugs, and reducing acute and long-term morbidity and mortality. Diagnosis, management, and prevention of specific SCAR conditions like SJS, TEN, and DRESS, along with understanding of pathomechanisms and genetics in SCAR development, are important for effective treatment. Supportive care and immunomodulating treatments for SCAR are discussed for comprehensive patient care and outcomes.
EPILEPSY & BEHAVIOR
(2021)
Article
Pharmacology & Pharmacy
Xiaoli Chen, Xilingyuan Chen, Zupeng Xiao, Hanyi Wu, Li Hu, Rentao Yu
Summary: This study found that the platelet-to-lymphocyte ratio (PLR) is closely related to the timing of glucocorticoid dose reduction in patients with cutaneous adverse drug reactions (cADRs). PLR values were positively correlated with higher Tr values, and PLR was identified as an independent risk factor for longer Tr values. Therefore, PLR may serve as a simple and convenient biomarker to assist clinicians in optimizing glucocorticoid therapy for cADRs.
TOXICOLOGY AND APPLIED PHARMACOLOGY
(2023)
Article
Infectious Diseases
Meifang Wang, Li Lin, Leyi Wang, Linfeng Li
Summary: Severe cutaneous adverse reactions (SCARs) are associated with various negative impacts. Early identification and understanding of patient characteristics are crucial. This study reports a case of acute generalized exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS) syndrome induced by carbamazepine and levofloxacin in a female patient. Relevant factors in the patient included age, allergy history, viral infection, and drugs interacting with specific HLA loci.
INFECTION AND DRUG RESISTANCE
(2023)