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
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)
Article
Dermatology
Natthiya Pholmoo, Supitchaya Thaiwat, Jettanong Klaewsongkram
Summary: Vitamin D deficiency is associated with allergic diseases and dermatological disorders. Patients with severe vitamin D deficiency have an increased risk of drug-induced non-immediate hypersensitivity reactions and in-hospital mortality.
EXPERIMENTAL DERMATOLOGY
(2023)
Article
Pharmacology & Pharmacy
Dongxuan Li, Jinghui Gou, Jun Zhu, Tongyan Zhang, Feng Liu, Daojun Zhang, Liyang Dai, Wenjun Li, Qinglong Liu, Chunmeng Qin, Qian Du, Songqing Liu
Summary: This study provides a comprehensive landscape of culprit-drugs for severe cutaneous adverse reactions (SCARs) by analyzing reports from the FDA Adverse Event Reporting System database. It reveals the risk characteristics of different drugs and may help optimize patient management.
FRONTIERS IN PHARMACOLOGY
(2023)
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)
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
Medicine, General & Internal
Fiona James, Michelle S. Y. Goh, Effie Mouhtouris, Sara Vogrin, Kyra Y. L. Chua, Natasha E. Holmes, Andrew Awad, Ana-Maria Copaescu, Joseph F. De Luca, Celia Zubrinich, Douglas Gin, Heather Cleland, Abby Douglas, Johannes S. Kern, Constance H. Katelaris, Francis Thien, Sara Barnes, James Yun, Winnie Tong, William B. Smith, Andrew Carr, Tara Anderson, Amy Legg, Jack Bourke, Laura K. Mackay, Ar Kar Aung, Elizabeth J. Phillips, Jason Trubiano
Summary: This study aims to examine the clinical presentation, drug causality, genomic predictors, potential diagnostic approaches, treatments, and long-term outcomes of severe cutaneous adverse reactions (SCAR) in Australia and New Zealand. The study will prospectively recruit adult and adolescent patients with SCAR and collect their DNA samples. Genomic testing and ex vivo testing will be performed to identify culprit drugs and prevent SCAR. Furthermore, the long-term outcomes of SCAR and patients' quality of life and mortality data will also be investigated.
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)
Article
Immunology
Grace Thompson, Andrew McLean-Tooke, Michaela Lucas
Summary: Current understanding of cross-reactivity in severe cutaneous adverse reactions to beta-lactam antibiotics is limited, and the underlying immunopathogenesis of these reactions is not completely understood. Research has shown that cross-reactivity or co-reactivity commonly occurred among the beta-lactam antibiotic class, but further investigation is needed to understand and investigate patterns of cross-reactivity.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Allergy
Hyun Jung Jin, Dong Yoon Kang, Young Hee Nam, Young Min Ye, Young-Il Koh, Gyu-Young Hur, Sae-Hoon Kim, Min-Suk Yang, Sujeong Kim, Yi Yeong Jeong, Min-Hye Kim, Jeong Hee Choi, Hye-Ryun Kang, Eun-Jung Jo, Hye-Kyung Park
Summary: Drug reaction with eosinophilia and systemic symptoms (DRESS) was more common among cases of ATD-related severe cutaneous adverse reactions (SCARs). Although most ATDs carry the risk of SCAR development, rifampin was the most frequently involved in causing SCARs. Multiple hypersensitivity reactions were frequently observed in ATD-related SCARs.
ALLERGY ASTHMA & IMMUNOLOGY RESEARCH
(2021)
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)
Review
Oncology
Emily Coleman, Brianna Olamiju, Jonathan Leventhal
Summary: Tyrosine kinase inhibitors (TKIs) have become a new frontier in cancer therapy, but they may lead to severe skin toxicities such as SJS, TEN, DRESS, and AGEP.
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
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
Pharmacology & Pharmacy
Nontaya Nakkam, Parinya Konyoung, Warayuwadee Amornpinyo, Niwat Saksit, Somsak Tiamkao, Usanee Khunarkornsiri, Kanyarat Khaeso, Oranuch Pattanacheewapull, Teekayu Plangkoon Jorns, Pansu Chumworathayi, Wichittra Tassaneeyakul
Summary: The study found significant associations between the HLA-B*15:02 and HLA-B75 alleles and CBZ-induced SJS/TEN, serving as strong genetic markers for predicting SCARs caused by CBZ in the Thai population.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)