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
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
Allergy
Andrew Gibson, Pooja Deshpande, Chelsea N. Campbell, Matthew S. Krantz, Eric Mukherjee, Maja Mockenhaupt, Munir Pirmohamed, Amy M. Palubinsky, Elizabeth J. Phillips
Summary: Severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), have significant impact on health and hinder drug development. Understanding the association between HLA class I alleles and SCARs has helped with prevention efforts and shed light on the immunopathogenesis. However, there is still much unknown about the specific risk alleles and antigens involved. Identifying the MHC-restricted drug-reactive peptides and genetic/environmental risk factors will be crucial for predicting individual and drug-level risks and developing targeted therapeutics.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
(2023)
Review
Dermatology
I. Torres-Navarro, B. de Unamuno-Bustos, R. Botella-Estrada
Summary: This review focused on BRAF/MEKi-induced SCARs. Vemurafenib was identified as the main culprit drug, with a mean onset time of 15.5 days for SJS/TEN and 11.4 days for DRESS. Hepatic involvement occurred in 96% of DRESS cases and renal alterations in 87% of patients.
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
(2021)
Review
Dermatology
Eman Salah
Summary: Toxic epidermal necrolysis (TEN) is a severe acute skin emergency, but there are many dermatoses that can mimic its presentation. These TEN mimics pose a diagnostic challenge and are important to differentiate from the actual TEN. This article aims to classify and highlight key clinical and laboratory points to help accurately diagnose TEN or TEN-like conditions.
INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY & LEPROLOGY
(2023)
Article
Pharmacology & Pharmacy
Pansakon Wattanachai, Warayuwadee Amornpinyo, Parinya Konyoung, Danklai Purimart, Usanee Khunarkornsiri, Oranuch Pattanacheewapull, Wichittra Tassaneeyakul, Nontaya Nakkam
Summary: This study extensively characterizes the associations between HLA genetic polymorphisms and several phenotypes of beta-lactam antibiotics-related severe cutaneous adverse reactions (SCARs).
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Multidisciplinary Sciences
Menglin Jiang, Jin Yang, Linlin Yang, Lina Wang, Ting Wang, Shengna Han, Ye Cheng, Zihua Chen, Yu Su, Lirong Zhang, Fanping Yang, Sheng-an Chen, Jin Zhang, Hao Xiong, Lanting Wang, Zhen Zhang, Li Ma, Xiaoqun Luo, Qinghe Xing
Summary: An association study was conducted to investigate the relationship between human leukocyte antigen (HLA) alleles and levofloxacin-induced severe cutaneous adverse drug reactions (LEV-SCARs). The study found that the carrier frequencies of HLA-B*13:01, HLA-B*13:02, and serotype B13 were significantly higher in patients with LEV-SCARs compared to levofloxacin-tolerant individuals. Molecular docking analysis and mass spectrometry provided insights into the binding and structural changes between levofloxacin and HLA-B*13:01/HLA-B*13:02. Prospective screening for serotype B13 and alternative drug treatment for carriers may reduce the incidence of LEV-SCARs.
Article
Dermatology
Marie Suzuki, Sachiko Koshikawa, Hideaki Watanabe, Naoko Inomata, Yukie Yamaguchi, Michiko Aihara, Hirohiko Sueki
Summary: Osteopontin (OPN) has attracted increasing attention for its roles in the immune system and allergic reactions. This study quantified serum OPN levels in patients with severe cutaneous adverse drug reactions, revealing higher levels in drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) patients compared to controls. The OPN level can be used to evaluate the severity of inflammation in patients experiencing drug reactions.
JOURNAL OF DERMATOLOGY
(2023)
Article
Dermatology
Mu-Tzu Chu, Chuang-Wei Wang, Wan-Chun Chang, Chun-Bing Chen, Wen-Hung Chung, Shuen-Iu Hung
Summary: The study highlights the effectiveness of granulysin-based lymphocyte activation tests in identifying aromatic antiepileptic drugs (AEDs) as culprits for severe cutaneous adverse reactions, assisting in confirming drug causality and preventing adverse drug reactions.
JOURNAL OF INVESTIGATIVE DERMATOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Thawinee Jantararoungtong, Therdpong Tempark, Napatrupron Koomdee, Sadeep Medhasi, Chonlaphat Sukasem
Summary: Pharmacogenomics has potential in reducing severe cutaneous adverse drug reactions (SCARs) by revealing associations between HLA genes and SCARs. Guidelines from regulatory agencies and professional organizations are available for the translation of SCARs pharmacogenomics research into clinical practice. However, adopting HLA screening on a wider scale in clinical practice requires significant resources and evidence of cost-effectiveness.
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
(2021)
Article
Dermatology
David Bomze, Eli Sprecher, Shamir Geller
Summary: Despite limited evidence, ivermectin has been linked to severe cutaneous adverse reactions (SCARs). Misuse of this drug has led to an increase in calls to poison-control centers and dermatologists should be aware of this issue.
JOURNAL OF DERMATOLOGY
(2022)
Article
Dermatology
C-B Chen, Y-E Chen, M-T Chu, C-W Wang, R. C-Y Hui, C-W Lu, Y-P Hsiao, C-Y Chu, M. M. Chang, C. M-T Cheung, C-Y Cheng, Y-W Wang, Y-J Lin, C-J Chang, S- Hung, W-H Chung
Summary: Research in Taiwan and Hong Kong focused on characterizing patients with AOA-SCAR, investigating the HLA association, and examining the utility of in vitro diagnostic methods. The study identified strontium ranelate as the most common causality of AOA-SCAR in Asian populations, with HLA-A*33:03 genetic allele being significantly associated with SR-SJS. The sensitivity of lymphocyte activation test (LAT) for identifying the culprit drug of SR-SJS was 83.3%.
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
(2021)
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
Immunology
Peng-Yu Chen, Zi-Yun Li, Sui-Qing Cai
Summary: Cadonilimab is the first approved bi-specific antibody for certain malignancies in June 2022, with a modified Fc structure to reduce immune-related adverse events. This report presents the first case of TEN-like reactions during the treatment of hepatocellular carcinoma with Cadonilimab, successfully treated with supplemental Adalimumab. The case highlights the potential risk of Cadonilimab-induced TEN and suggests Adalimumab as a favorable option for refractory Cadonilimab-related TEN treatment.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Allergy
D. Rojas Mejia, R. D. Zwiener, R. Cardona Villa, L. F. Ramirez, D. L. Silva Espinosa, V. A. Zanacchi, P. Piraino Sosa, L. F. Ensina, P. Giavina Bianchi, N. Coelho Portilho, M. Vivolo Aun, E. Matos Benavides, D. M. Martinez Ruiz, E. Jares, C. D. Serrano Reyes
Summary: This study characterized patients with severe cutaneous adverse reactions to drugs (SCARs) in 8 healthcare institutions in Latin America. DRESS-DIHS was the most frequently reported clinical entity, with aromatic anticonvulsants being the main triggers. Most patients received systemic corticosteroid treatment, but complications were frequent with a mortality rate of 4.3%.
JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
(2021)