Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics
SCARs are rare and life-threatening hypersensitivity reactions. In general, the increased duration of hospital stays and the associated cost burden are common issues, and in the worst-case scenario, they can result in mortality. SCARs are delayed T cell-mediated hypersensitivity reactions. Recovery...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.832048/full |
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| author | Therdpong Tempark Therdpong Tempark Shobana John Shobana John Pawinee Rerknimitr Pawinee Rerknimitr Patompong Satapornpong Patompong Satapornpong Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem |
| author_facet | Therdpong Tempark Therdpong Tempark Shobana John Shobana John Pawinee Rerknimitr Pawinee Rerknimitr Patompong Satapornpong Patompong Satapornpong Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem |
| author_sort | Therdpong Tempark |
| collection | DOAJ |
| description | SCARs are rare and life-threatening hypersensitivity reactions. In general, the increased duration of hospital stays and the associated cost burden are common issues, and in the worst-case scenario, they can result in mortality. SCARs are delayed T cell-mediated hypersensitivity reactions. Recovery can take from 2 weeks to many months after dechallenging the culprit drugs. Genetic polymorphism of the HLA genes may change the selection and presentation of antigens, allowing toxic drug metabolites to initiate immunological reactions. However, each SCARs has a different onset latency period, clinical features, or morphological pattern. This explains that, other than HLA mutations, other immuno-pathogenesis may be involved in drug-induced severe cutaneous reactions. This review will discuss the clinical morphology of various SCARs, various immune pathogenesis models, diagnostic criteria, treatments, the association of various drug-induced reactions and susceptible alleles in different populations, and the successful implementation of pharmacogenomics in Thailand for the prevention of SCARs. |
| first_indexed | 2024-04-14T07:38:11Z |
| format | Article |
| id | doaj.art-fdb8c01806a1478c9aadde281a15ff29 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-14T07:38:11Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-fdb8c01806a1478c9aadde281a15ff292022-12-22T02:05:37ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-04-011310.3389/fphar.2022.832048832048Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and PharmacogenomicsTherdpong Tempark0Therdpong Tempark1Shobana John2Shobana John3Pawinee Rerknimitr4Pawinee Rerknimitr5Patompong Satapornpong6Patompong Satapornpong7Chonlaphat Sukasem8Chonlaphat Sukasem9Chonlaphat Sukasem10Chonlaphat Sukasem11Chonlaphat Sukasem12Chonlaphat Sukasem13Division of Dermatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandThe Pediatrics-Thai Severe Cutaneous Adverse Drug Reaction (Ped-Thai-SCAR) Research Group, Bangkok, ThailandDivision of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandLaboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, ThailandThe Thai Severe Cutaneous Adverse Drug Reaction (Thai-SCAR) Research Group, Bangkok, ThailandDivision of Dermatology, Department of Medicine, Faculty of Medicine, Skin, and Allergy Research Unit, Chulalongkorn University, Bangkok, ThailandDivision of General Pharmacy Practice, Department of Pharmaceutical Care, College of Pharmacy, Rangsit University, Pathum Thani, ThailandExcellence Pharmacogenomics and Precision Medicine Centre, College of Pharmacy, Rangsit University, Pathum Thani, ThailandThe Pediatrics-Thai Severe Cutaneous Adverse Drug Reaction (Ped-Thai-SCAR) Research Group, Bangkok, ThailandDivision of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandLaboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, ThailandThe Thai Severe Cutaneous Adverse Drug Reaction (Thai-SCAR) Research Group, Bangkok, ThailandPharmacogenomics and Precision Medicine, The Preventive Genomics & Family Check-up Services Center, Bumrungrad International Hospital, Bangkok, Thailand0MRC Centre for Drug Safety Science, Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United KingdomSCARs are rare and life-threatening hypersensitivity reactions. In general, the increased duration of hospital stays and the associated cost burden are common issues, and in the worst-case scenario, they can result in mortality. SCARs are delayed T cell-mediated hypersensitivity reactions. Recovery can take from 2 weeks to many months after dechallenging the culprit drugs. Genetic polymorphism of the HLA genes may change the selection and presentation of antigens, allowing toxic drug metabolites to initiate immunological reactions. However, each SCARs has a different onset latency period, clinical features, or morphological pattern. This explains that, other than HLA mutations, other immuno-pathogenesis may be involved in drug-induced severe cutaneous reactions. This review will discuss the clinical morphology of various SCARs, various immune pathogenesis models, diagnostic criteria, treatments, the association of various drug-induced reactions and susceptible alleles in different populations, and the successful implementation of pharmacogenomics in Thailand for the prevention of SCARs.https://www.frontiersin.org/articles/10.3389/fphar.2022.832048/fullSCARspharmacogenomicsPGx implementationThailandimmunopathogenesis of SCARsrisk factors |
| spellingShingle | Therdpong Tempark Therdpong Tempark Shobana John Shobana John Pawinee Rerknimitr Pawinee Rerknimitr Patompong Satapornpong Patompong Satapornpong Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Chonlaphat Sukasem Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics Frontiers in Pharmacology SCARs pharmacogenomics PGx implementation Thailand immunopathogenesis of SCARs risk factors |
| title | Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics |
| title_full | Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics |
| title_fullStr | Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics |
| title_full_unstemmed | Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics |
| title_short | Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics |
| title_sort | drug induced severe cutaneous adverse reactions insights into clinical presentation immunopathogenesis diagnostic methods treatment and pharmacogenomics |
| topic | SCARs pharmacogenomics PGx implementation Thailand immunopathogenesis of SCARs risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.832048/full |
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