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Title: The assessment of severe cutaneous adverse drug reactions.
Austin Authors: Copaescu, Ana M;Trublano, Jason A
Affiliation: Infectious Diseases
McGill University Health Centre, McGill University, Montreal, Quebec, Canada
University of Melbourne, Parkville, Victoria, Australia
Issue Date: Apr-2022
Date: 2022-04-01
Publication information: Australian Prescriber 2022; 45(2): 43-48
Abstract: Severe cutaneous adverse drug reactions include Stevens-Johnson syndrome, toxic epidermal necrolysis and acute generalised exanthematous pustulosis. These eruptions are a type of delayed hypersensitivity reaction and can be life-threatening. The assessment of a severe cutaneous drug reaction requires a detailed clinical history and examination to identify the culprit drug and evaluate the allergy. Allopurinol, antibiotics and anticonvulsants are often implicated. Patch testing and delayed intradermal testing can assist in determining if the reaction was allergic, however there is limited evidence about the sensitivity and specificity of skin testing in severe cutaneous adverse drug reactions. If the testing is non-conclusive or negative, it is recommended to avoid the suspected culprit drug and any structurally similar drug in future. Any decision to reintroduce a drug should be made after considering the harm-benefit ratio. Caution is also needed if considering a possibly cross-reactive drug in a patient with a history of severe cutaneous adverse drug reactions.
DOI: 10.18773/austprescr.2022.010
ORCID: 0000-0002-9183-5032
Journal: Australian Prescriber
PubMed URL: 35592375
PubMed URL:
ISSN: 0312-8008
Type: Journal Article
Subjects: Stevens- Johnson syndrome
acute generalised exanthematous pustulosis
adverse drug reactions
delayed hypersensitivity
drug eruptions
Appears in Collections:Journal articles

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