Delayed Skin Testing for Systemic Medications: Helpful or Not?

The Journal of Allergy and Clinical Immunology In Practice, Год журнала: 2024, Номер 12(9), С. 2268 - 2277

Опубликована: Июль 6, 2024

Cutaneous adverse drug reactions collectively are delayed such as morbilliform eruption and severe cutaneous (SCARs). Morbilliform may wane over time, be the result of viral interactions, amenable to slow reintroduction or rechallenge, whereas SCARs HLA class I restricted, T-cell-mediated that demonstrate durable immunity warrant lifelong avoidance. reaction with eosinophilia systemic symptoms, Stevens-Johnson syndrome toxic epidermal necrolysis, acute generalized exanthematous pustulosis, bullous fixed often occur in setting multiple drugs dosed together. Collectively, they lead significant morbidity, mortality, safety concerns could severely limit future treatment options. Currently, no single combination diagnostic tests for ex vivo vitro testing, (skin) other adjunctive typing have 100% negative predictive value. In this "Controversies Allergy Review" article, we review current literature on skin testing (patch prick/intradermal test) critically assess evidence base its utility across different clinical phenotypes hypersensitivity reactions.

Язык: Английский

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Palliative Care for Severe Cutaneous Adverse Reactions: Gaps, Challenges, and the Way Forward

Journal of Pain and Symptom Management, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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Proteins lead the way: JAK inhibitors as a new treatment option in toxic epidermal necrolysis

Signal Transduction and Targeted Therapy, Год журнала: 2025, Номер 10(1)

Опубликована: Фев. 2, 2025

Язык: Английский

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Extracellular Granzyme B mediates degradation of Collagen XVII in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Journal of Investigative Dermatology, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

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Characterization of Demographics, Drug Latency, and Mortality of Severe Cutaneous Adverse Reactions in an FDA Pharmacovigilance Database

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Март 6, 2025

Abstract Background Severe cutaneous adverse reactions (SCARs) are rare, life-threatening conditions associated with drug exposure. These differ globally in causative agents, demographics, and latency (time between administration reaction). We provide a comprehensive survey of SCAR pharmacovigilance database maintained by the FDA. Methods After sanitization, FDA Adverse Events Reporting System (FAERS) from January 2004 to December 2003 was queried for cases. Disproportionality analyses measured associations drugs SCAR. Random forests were used determine influence covariates on mortality. Findings A total 56,683 cases reported, comprising 0.33% reports. 49.4% female (28008). The median age patients 53 (interquartile range [IQR] 32-68), significant differences phenotypes. There has been an increase reporting over time, particularly biologics immune checkpoint inhibitors (ICI). Over 200 had positive disproportionality signals. Several co-reported two SJS-TEN, DRESS, and/or AGEP, indicating possibility intermediate TTE analysis showed is most influential variable latency, followed number concomitant drugs. Mortality varied increased Interpretation This largest retrospective study date shows variety phenotypes, demographic variables, latencies, mortality this population. demonstrates power using databases rare reactions. Continued mining these databases, electronic health records, prospective data can expand upon results, better characterize variations, improve recognition care Funding National Institutes Health, Vanderbilt University Medical Center.

Язык: Английский

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Pharmacogenomic variants in the Pumi population from Yunnan, China

Gene, Год журнала: 2025, Номер unknown, С. 149421 - 149421

Опубликована: Март 1, 2025

Язык: Английский

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TOP10‐SCAR: A Global Pharmacovigilance Study on Medications Most Frequently Related to Severe Cutaneous Adverse Reactions

Allergy, Год журнала: 2025, Номер unknown

Опубликована: Апрель 2, 2025

Язык: Английский

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The Synergistic Mechanisms and Prospects of Transarterial Chemoembolization Combined with Immunotherapy for Hepatocellular Carcinoma

Journal of Hepatocellular Carcinoma, Год журнала: 2025, Номер Volume 12, С. 841 - 854

Опубликована: Апрель 1, 2025

Hepatocellular carcinoma (HCC) represents a highly aggressive form of liver neoplasm that presents various therapeutic obstacles. Recently, the synergistic use transarterial chemoembolization (TACE) in conjunction with immunotherapy has attracted considerable interest within medical community. This review aims to explore mechanisms between TACE and immunotherapy, analyze current research evidence, discuss their potential applications treatment HCC. By examining how can enhance efficacy we seek provide direction for future emphasize importance personalized strategies managing

Язык: Английский

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Plasmapheresis for refractory toxic epidermal necrolysis unresponsive to conventional therapy: a case report and literature review

Frontiers in Immunology, Год журнала: 2025, Номер 16

Опубликована: Май 28, 2025

Toxic epidermal necrolysis (TEN) is a rare and life-threatening severe cutaneous adverse reaction. The conventional treatment approach includes immunomodulatory therapies, such as systemic corticosteroids, cyclosporine, intravenous immunoglobulin (IVIG), tumor necrosis factor-alpha (TNF-α) inhibitors. Plasmapheresis, potential for TEN, rarely used in patients with refractory TEN. We report successful case of plasmapheresis patient TEN who did not respond to treatment, we provide literature review. A 65-year-old female presented diffuse erythematous papules covering her entire body, along multiple blisters bullae, partial detachment the epidermis mucosa. area exfoliation exceeded 30% total body surface area, Nikolsky’s sign was positive. Despite week methylprednisolone numerous bullae developed, expanded 62%. IVIG TNF-α inhibitors were subsequently added, but disease remained uncontrolled. Plasmapheresis initiated. Epithelial regeneration observed after three days plasmapheresis. After given 5 times, finally recovered. This highlights significance particularly when therapies are ineffective. More studies needed future confirm efficacy treatment.

Язык: Английский

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Updates in the pathogenesis of SJS/TEN

Allergology International, Год журнала: 2025, Номер unknown

Опубликована: Июнь 1, 2025

Язык: Английский

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