Severe cutaneous adverse reactions: impact of immunology, genetics, and pharmacology

SEVERE DRUG REACTIONS AND REACTIONS TO CHEMOTHERAPEUTIC AGENTS

Severe cutaneous adverse reactions: impact of immunology, genetics, and pharmacology

Mar
2014
Vol. 33. No. 1
Joanna L. Harp, MD | Kanade Shinkai, MD | Melissa A. Kinnebrew, PhD

Severe cutaneous adverse reactions, though rare, represent
a mucocutaneous presentation of adverse drug
responses associated with significant morbidity and mortality.
Here, we review the recent literature highlighting the
roles of selective immune responses, genetic factors, and
drug metabolism in increasing susceptibility of a given
patient to these rare and severe reactions. Further understanding
of these factors and their relative contributions to
a severe drug reaction may hold important implications
for future patient-specific pharmacogenomic and immunologic
profiling in an effort to personalize prescribing patterns
by clinicians. Emerging concepts, such as the role of
viral reactivation and the presence of overlapping clinical
features in severe drug eruptions, are also discussed.

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