Kanade Shinkai

Guest Editor for the following articles:

Vol. 33. No. 1

Dermatologic adverse events to chemotherapeutic agents, Part 1: cytotoxic agents, epidermal growth factor inhibitors, multikinase inhibitors, and proteasome inhibitors

Milan J. Anadkat, MD | Rachel L. Kyllo, BS

Dermatologic toxicities have profound effects on patients
receiving chemotherapy for cancer treatment. Cytotoxic
chemotherapies are associated with a number of nonspecific
dermatologic adverse events including alopecia, mucositis,
and onychodystrophy. Targeted therapies including
epidermal growth factor inhibitors, multikinase inhibitors,
and proteasome inhibitors are associated with different
skin reactions that are class-specific. In Part 1 of this
review, we examine the presentations of the most common
dermatologic adverse events associated with the above
drugs and discuss the strategies used for their prevention
and treatment.

Vol. 33. No. 1

Dermatologic adverse events to chemotherapeutic agents, Part 2: BRAF inhibitors, MEK inhibitors, and ipilimumab

Jennifer Nam Choi, MD

The advent of novel targeted chemotherapeutic agents
and immunotherapies has dramatically changed the
arena of cancer treatment in recent years. BRAF inhibitors,
MEK inhibitors, and ipilimumab are among the newer
chemotherapy drugs that are being used at an increasing
rate. Dermatologic adverse events to these medications
are common, and it is important for dermatologists and
oncologists alike to learn to recognize and treat such
side effects in order to maintain both patients’ quality of
life and their anticancer treatment. This review describes
the cutaneous side effects seen with BRAF inhibitors (eg,
maculopapular eruption, photosensitivity, squamoproliferative
growths, melanocytic proliferations), MEK inhibitors (eg,
papulopustular eruption), and ipilimumab (eg, maculopapular
eruption, vitiligo), with a mention of vismodegib
and anti-PD-1 agents.

Vol. 33. No. 1

Epidemiology of severe drug hypersensitivity

Neil H. Shear, MD | Philip M. Laws, MDChB | Roni P. Dodiuk-Gad, MD

Epidemiological studies of severe drug hypersensitivities
are important to understanding the morbidity and
mortality of this heterogeneous group of disorders. These
insights also allow greater identification of at-risk patient
groups. However, epidemiological studies of drug hypersensitivity
reactions are challenging due to the variable
diagnostic criteria applied and incomplete data sets
studied. We review the epidemiology of severe drug hypersensitivity
reactions with a particular focus on severe
cutaneous adverse reactions (SCARs). SCAR diseases
include: Stevens-Johnson syndrome, toxic epidermal
necrolysis, drug rash eosinophilia and systemic symptoms,
serum-sickness–like reaction and acute generalized
exanthematous pustulosis.

Vol. 33. No. 1

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

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.

Vol. 33. No. 1

Severe drug-induced dermatoses

Iris Ahronowitz, MD | Lindy P. Fox, MD

A variety of common dermatoses are known to have
drug-induced variants. This article discusses the clinical
presentation, time frames, reported culprit medications,
pathophysiology and management of drug-induced
lupus, cutaneous vasculitis, pemphigus, pemphigoid,
linear IgA bullous dermatosis, Sweet’s syndrome, erythema
nodosum, pyoderma gangrenosum, pseudolymphoma,
lichen planus, and psoriasis.