Recent advances in the understanding of severe cutaneous adverse reactions

Br J Dermatol. 2017 Nov;177(5):1234-1247. doi: 10.1111/bjd.15423. Epub 2017 Sep 29.


Severe cutaneous adverse reactions (SCARs) encompass a heterogeneous group of delayed hypersensitivity reactions, which are most frequently caused by drugs. Our understanding of several aspects of SCAR syndromes has evolved considerably over the last decade. This review explores evolving knowledge of the immunopathogenic mechanisms, pharmacogenomic associations, in vivo and ex vivo diagnostics for causality assessment, and medication cross-reactivity data related to SCAR syndromes. Given the rarity and severity of these diseases, multidisciplinary collaboration through large international, national and/or multicentre networks to collect prospective data on patients with SCAR syndromes should be prioritized. This will further enhance a systematized framework for translating epidemiological, clinical and immunopathogenetic advances into preventive efforts and improved outcomes for patients.

Publication types

  • Review

MeSH terms

  • Allopurinol / adverse effects
  • Anticonvulsants / adverse effects
  • Carbamazepine / adverse effects
  • Cephalosporins / adverse effects
  • Dideoxynucleosides / adverse effects
  • Drug Eruptions / diagnosis
  • Drug Eruptions / etiology*
  • Drug Eruptions / immunology
  • Drug Interactions
  • Herpesviridae Infections / chemically induced
  • Humans
  • Leukocytes, Mononuclear / immunology
  • Pharmacogenetics / trends
  • Prospective Studies
  • Skin Tests / methods
  • T-Lymphocytes / immunology
  • Virus Activation / drug effects
  • Virus Latency / drug effects
  • beta-Lactams / adverse effects


  • Anticonvulsants
  • Cephalosporins
  • Dideoxynucleosides
  • beta-Lactams
  • Carbamazepine
  • Allopurinol
  • abacavir