Human leukocyte antigen-associated severe cutaneous adverse drug reactions: from bedside to bench and beyond

Asia Pacific Allergy
Dinh Van NguyenSheryl van Nunen

Abstract

Despite their being uncommon, severe cutaneous adverse drug reactions (SCARs) result in a very great burden of disease. These reactions not only carry with them a high mortality (10%-50%) and high morbidity (60%) with severe ocular complications, alopecia, oral and dental complications and development of autoimmune diseases, but also create a substantial economic burden for patients' families and society. SCARs are, therefore, an important medical problem needing a solution in many countries, especially in Asia. The clinical spectrum of SCARs comprises Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS (drug rash with eosinophilia and systemic symptoms) (also known as drug hypersensitivity syndrome or drug-induced hypersensitivity syndrome) and acute generalised exanthematous pustulosis. Recent crucial advances in determining genetic susceptibility and understanding how T cells recognise certain medications or their metabolites via the major histocompatibility complex and the effects of cofactors, have led to the implementation of cost-effective screening programs enabling prevention in a number of countries, and to further understanding of the patho-mechanisms involved in SCARs and their significance. In this review, ...Continue Reading

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Citations

Aug 7, 2019·Asia Pacific Allergy·Jiu-Yao Wang
Jun 22, 2021·Expert Opinion on Drug Metabolism & Toxicology·Thawinee JantararoungtongChonlaphat Sukasem
Jul 18, 2021·Clinical Reviews in Allergy & Immunology·Jingzhan ZhangXiaojing Kang

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