Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Part II diagnosis and management

被引：25

作者：

Wei, Brian M. ^{[1
]}

Fox, Lindy P. ^{[2
]}

Kaffenberger, Benjamin H. ^{[3
]}

Korman, Abraham M. ^{[3
]}

Micheletti, Robert G. ^{[4
]}

Mostaghimi, Arash ^{[5
]}

Noe, Megan H. ^{[5
]}

Rosenbach, Misha ^{[4
]}

Shinkai, Kanade ^{[2
]}

Kwah, Jason H. ^{[6
]}

Phillips, Elizabeth J. ^{[7
]}

Bolognia, Jean L. ^{[1
]}

Damsky, William ^{[8
]}

Nelson, Caroline A. ^{[1
,9
]}

机构：

[1] Yale Sch Med, Dept Dermatol, New Haven, CT USA

[2] Univ Calif San Francisco, Dept Dermatol, San Francisco, CA USA

[3] Ohio State Univ, Dept Dermatol, Columbus, OH USA

[4] Univ Penn, Perelman Sch Med, Dept Dermatol, Philadelphia, PA USA

[5] Harvard Med Sch, Brigham & Womens Hosp, Dept Dermatol, Boston, MA USA

[6] Yale Sch Med, Dept Med, Sect Rheumatol Allergy & Immunol, New Haven, CT USA

[7] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN USA

[8] Yale Sch Med, Dept Pathol, New Haven, CT USA

[9] Yale Univ, Sch Med, Dept Dermatol, 15 York St, New Haven, CT 06510 USA

来源：

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY | 2024年 / 90卷 / 05期

关键词：

delayed hypersensitivity reaction; DHR; DiHS; DRESS; drug rash; drug-induced hypersensitivity syndrome; drug reaction; drug reaction with eosinophilia and systemic symptoms; eosinophilia; exanthem; exanthematous drug eruption; hypersensitivity; maculopapular eruption; morbilliform eruption; severe cutaneous adverse drug reaction; SCAR; STEVENS-JOHNSON-SYNDROME; SYNDROME (DIHS)/DRUG REACTION; VERSUS-HOST-DISEASE; GENERALIZED EXANTHEMATOUS PUSTULOSIS; REGULATED CHEMOKINE TARC/CCL17; CUTANEOUS LUPUS-ERYTHEMATOSUS; TOXIC EPIDERMAL NECROLYSIS; DRESS-SYNDROME; INTRAVENOUS IMMUNOGLOBULIN; VIRAL REACTIVATION;

D O I：

10.1016/j.jaad.2023.02.073

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Drug -induced hypersensitivity syndrome, also known as drug reaction with eosinophilia and systemic symptoms, is a severe cutaneous adverse reaction characterized by an exanthem, fever, and hematologic and visceral organ involvement. The differential diagnosis includes other cutaneous adverse reactions, infections, inflammatory and autoimmune diseases, and neoplastic disorders. Three sets of diagnostic criteria have been proposed; however, consensus is lacking. The cornerstone of management is immediate discontinuation of the suspected drug culprit. Systemic corticosteroids remain first -line therapy, but the literature on steroid -sparing agents is expanding. Longitudinal evaluation for sequelae is recommended. Adjunctive tests for risk stratification and drug culprit identification remain under investigation. Part II of this continuing medical education activity begins by exploring the differential diagnosis and diagnosis of druginduced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms and concludes with an evidence -based overview of evaluation and treatment. ( J Am Acad Dermatol 2024;90:911-26.)

引用

页码：911 / 926

页数：16

共 179 条

[1] Pediatric drug reaction with eosinophilia and systemic symptoms: A systematic review of the literature, with a focus on relapsing cases [J].