Pharmacogenetics in clinical dermatology

Systemic therapies are increasingly used in the management of common skin diseases, and drug toxicity and relative lack of efficacy remain significant problems. In addition, we are unable to predict life-threatening adverse reactions such as toxic epidermal necrolysis. Pharmacogenetics, the study of how genetic differences influence the variability of individual patient responses to drugs, aims to distinguish responders from non-responders and predict those in whom toxicity is likely. Successful application of pharmacogenetics should lead to rationalized drug therapy. Recent advances in molecular genetic techniques such as high-throughput genotyping and microarrays have the potential to provide a practicable and economical approach to future pharmacogenetic testing. Pharmacogenetics will change not only the way drugs are selected but will also impact on clinical trial design and the costs of healthcare delivery.