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Adverse cutaneous drug eruptions: current understanding

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Abstract

Adverse cutaneous drug reactions are recognized as being major health problems worldwide causing considerable costs for health care systems. Most adverse cutaneous drug reactions follow a benign course; however, up to 2 % of all adverse cutaneous drug eruptions are severe and life-threatening. These include acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Physicians should be aware of specific red flags to rapidly identify these severe cutaneous drug eruptions and initiate appropriate treatment. Besides significant progress in clinical classification and treatment, recent studies have greatly enhanced our understanding in the pathophysiology of adverse cutaneous drug reactions. Genetic susceptibilities to certain drugs have been identified in SJS/TEN patients, viral reactivation in DRESS has been elucidated, and the discovery of tissue resident memory T cells helps to better understand the recurrent site-specific inflammation in patients with fixed drug eruption.

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The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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Authors and Affiliations

  1. Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland

    W. Hoetzenecker, M. Nägeli, I. Saulite, P. Schmid-Grendelmeier, E. Guenova, A. Cozzio & L. E. French

  2. Medical Directorate, University Hospital of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    E. T. Mehra

  3. Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    A. N. Jensen

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  1. W. Hoetzenecker
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  2. M. Nägeli
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  5. I. Saulite
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  7. E. Guenova
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  8. A. Cozzio
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  9. L. E. French
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Correspondence to W. Hoetzenecker or L. E. French.

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This article is a contribution to the Special Issue on Immunodermatology - Guest Editors: Lars French and Alexander Navarini

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Hoetzenecker, W., Nägeli, M., Mehra, E.T. et al. Adverse cutaneous drug eruptions: current understanding. Semin Immunopathol 38, 75–86 (2016). https://doi.org/10.1007/s00281-015-0540-2

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