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[Severe Skin Reactions Due to New Medications]

Overview
Journal Hautarzt
Specialty Dermatology
Date 2018 Mar 24
PMID 29568997
Citations 2
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Abstract

Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and a specific form of hypersensitivity syndrome which is nowadays called "drug reaction with eosinophilia and systemic symptoms" (DRESS) are severe, mainly drug-induced skin reactions. Whereas SJS/TEN is considered one reaction entity of different severity, DRESS has to be distinguished from SJS/TEN but also from other severe exanthems due to multiorgan involvement. Although SJS/TEN is generally referred to as drug reaction, in total only about three quarters of the cases are actually caused by drugs. After the clinical diagnosis is made, identification of the potential inducing factor is most important. In case medications are considered as causal, their withdrawal plays a key role in management. In order to identify and withdraw the inducing agent, a detailed and thorough medication history must be obtained. Agents identified or confirmed as inducers of SJS/TEN by pharmacoepidemiological studies are allopurinol, antibacterial sulfonamides, various antiepileptics, nevirapine and nonsteroidal anti-inflammatory drugs of the oxicam-type. Among drugs inducing DRESS are also various antiepileptics, but in addition allopurinol, sulfonamides and minocycline. Some cases of SJS/TEN and DRESS associated with the use of new medication, including targeted therapies and biologicals, have been observed.

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[Acute life-threatening drug reactions of the skin].

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[Cutaneous side effects of targeted therapies].

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References
1.
Mockenhaupt M, Naldi L, Correia O, Schroder W, Roujeau J . Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study. Arch Dermatol. 2002; 138(8):1019-24. DOI: 10.1001/archderm.138.8.1019. View

2.
Rzany B, Mockenhaupt M, Baur S, Schroder W, Stocker U, Mueller J . Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990-1992): structure and results of a population-based registry. J Clin Epidemiol. 1996; 49(7):769-73. DOI: 10.1016/0895-4356(96)00035-2. View

3.
Mockenhaupt M, Idzko M, Grosber M, Schopf E, Norgauer J . Epidemiology of staphylococcal scalded skin syndrome in Germany. J Invest Dermatol. 2005; 124(4):700-3. DOI: 10.1111/j.0022-202X.2005.23642.x. View

4.
Paulmann M, Mockenhaupt M . Severe drug-induced skin reactions: clinical features, diagnosis, etiology, and therapy. J Dtsch Dermatol Ges. 2015; 13(7):625-45. DOI: 10.1111/ddg.12747. View

5.
Phillips E, Chung W, Mockenhaupt M, Roujeau J, Mallal S . Drug hypersensitivity: pharmacogenetics and clinical syndromes. J Allergy Clin Immunol. 2011; 127(3 Suppl):S60-6. PMC: 3061439. DOI: 10.1016/j.jaci.2010.11.046. View