Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics
6
Issued Date
2022-04-20
Resource Type
eISSN
16639812
Scopus ID
2-s2.0-85129462048
Journal Title
Frontiers in Pharmacology
Volume
13
Rights Holder(s)
SCOPUS
Bibliographic Citation
Frontiers in Pharmacology Vol.13 (2022)
Suggested Citation
Tempark T., John S., Rerknimitr P., Satapornpong P., Sukasem C. Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics. Frontiers in Pharmacology Vol.13 (2022). doi:10.3389/fphar.2022.832048 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85957
Title
Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
SCARs are rare and life-threatening hypersensitivity reactions. In general, the increased duration of hospital stays and the associated cost burden are common issues, and in the worst-case scenario, they can result in mortality. SCARs are delayed T cell-mediated hypersensitivity reactions. Recovery can take from 2 weeks to many months after dechallenging the culprit drugs. Genetic polymorphism of the HLA genes may change the selection and presentation of antigens, allowing toxic drug metabolites to initiate immunological reactions. However, each SCARs has a different onset latency period, clinical features, or morphological pattern. This explains that, other than HLA mutations, other immuno-pathogenesis may be involved in drug-induced severe cutaneous reactions. This review will discuss the clinical morphology of various SCARs, various immune pathogenesis models, diagnostic criteria, treatments, the association of various drug-induced reactions and susceptible alleles in different populations, and the successful implementation of pharmacogenomics in Thailand for the prevention of SCARs.