Adverse drug reaction
Adverse drug reactions (ADRs) are unintended and undesirable reactions that may arise even from standardized dosage of drugs, and causality with the drug cannot be ruled out.1 The most common symptoms of ADRs are skin symptoms which are easily recognized. In most cases, ADRs can be improved by discontinuing the culprit drug. However, severe cutaneous adverse reactions (SCARs) can be fatal and life-threatening, so they should be identified as early as possible and treated properly.
Severe Cutaneous Adverse Reaction
Severe cutaneous adverse reactions (SCARs) are life-threatening hypersensitivity reactions to drugs, which include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP).2 SCARs are associated with a high mortality rate (up to 40%) and carry a nonnegligible risk of long‐term sequelae, such as dystrophic scars and synechiae, visual loss, and end‐organ failure, which may critically affect patient quality of life.3
The terms describing DRESS syndrome have varied in the literature, with various terms preferred by some authors, including drug hypersensitivity syndrome, drug-induced hypersensitivity syndrome (DiHS) and drug-induced delayed multiorgan hypersensitivity syndrome; hereafter, we will describe it as ‘DRESS’ in a unified.1
Reference
1.Joint Task Force on Practice P, American Academy of Allergy A, Immunology, et al. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol 2010; 105(4): 259-73.2.Shim JS, Yun J, Kim MY, et al. The Presence of HLA-B75, DR13 Homozygosity, or DR14 Additionally Increases the Risk of Allopurinol-Induced Severe Cutaneous Adverse Reactions in HLA-B*58:01 Carriers. J Allergy Clin Immunol Pract 2019; 7(4): 1261-70.
3.Lin CW, Huang WI, Chao PH, Chen WW, Hsiao FY. Temporal trends and patterns in carbamazepine use, related severe cutaneous adverse reactions, and HLA-B*15:02 screening: A nationwide study. Epilepsia 2018; 59(12): 2325-39.
