Severe cutaneous adverse reactions to drugs

Lancet. 2017 Oct 28;390(10106):1996-2011. doi: 10.1016/S0140-6736(16)30378-6. Epub 2017 May 2.


During the past decade, major advances have been made in the accurate diagnosis of severe cutaneous adverse reactions (SCARs) to drugs, management of their manifestations, and identification of their pathogenetic mechanisms and at-risk populations. Early recognition and diagnosis of SCARs are key in the identification of culprit drugs. SCARS are potentially life threatening, and associated with various clinical patterns and morbidity during the acute stage of Stevens-Johnson syndrome and toxic epidermal necrolysis, drug reactions with eosinophilia and systemic symptoms, and acute generalised exanthematous pustulosis. Early drug withdrawal is mandatory in all SCARs. Physicians' knowledge is essential to the improvement of diagnosis and management, and in the limitation and prevention of long-term sequelae. This Seminar provides the tools to help physicians in their clinical approach and investigations of SCARs.

Publication types

  • Review

MeSH terms

  • Acute Generalized Exanthematous Pustulosis / diagnosis*
  • Acute Generalized Exanthematous Pustulosis / epidemiology
  • Acute Generalized Exanthematous Pustulosis / etiology
  • Diagnosis, Differential
  • Drug Hypersensitivity Syndrome / diagnosis*
  • Drug Hypersensitivity Syndrome / epidemiology*
  • Drug Hypersensitivity Syndrome / etiology
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Female
  • Humans
  • Incidence
  • Male
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / epidemiology
  • Stevens-Johnson Syndrome / etiology