PMID- 24820797
OWN - NLM
STAT- MEDLINE
DCOM- 20150409
LR  - 20211021
IS  - 1432-1173 (Electronic)
IS  - 0017-8470 (Linking)
VI  - 65
IP  - 5
DP  - 2014 May
TI  - [Delayed-type cutaneous drug reactions. Pathogenesis, clinical features and 
      histology].
PG  - 397-408
LID - 10.1007/s00105-013-2696-9 [doi]
AB  - BACKGROUND: Cutaneous reactions to drugs can be subdivided in different ways. In 
      addition to the standard classification according to the etiopathogenesis there 
      are also classifications based predominantly on morphological criteria. The 
      majority of drug-related cutaneous adverse reactions are immunological reactions 
      which are collectively classified under the term hypersensitivity. These 
      reactions are based on drug-specific immunoglobulin E (IgE) or cell-mediated 
      mechanisms, not on the mechanism of action of the drug and are unpredictable. 
      Delayed type reactions to drugs are forms of type IV T-cell mediated 
      hypersensitivity. A prerequisite is a stable association of a pharmaceutical 
      substance with a protein so that hapten-protein conjugates can be produced. The 
      most common clinical symptom is maculopapular (morbilliform) drug-related 
      exanthema. This article also examines lichen planus like drug reaction and 
      drug-induced (hematogenic) allergic contact dermatitis in more detail. 
      DIAGNOSTICS: The diagnostics are never trivial but also include the 
      differentiation from viral exanthema and initial phases of severe cutaneous 
      adverse reactions, such as toxic epidermal necrolysis. In addition to the 
      morphological classification, the final diagnosis encompasses the interpretation 
      of histopathological alterations in the skin biopsy, analysis of patient 
      medication history, laboratory results and inclusion of data from the literature. 
      Patch tests can also have additional diagnostic benefits. In vitro tests which 
      involve the cellular incubation of the drug responsible should be reserved for 
      specialized laboratories. A prerequisite for successful treatment is immediate 
      termination of the drug responsible. THERAPY AND PROGNOSIS: Therapy is 
      symptomatic with topical and also short-term systemic steroids and 
      antihistamines. The prognosis is very good.
FAU - Ziemer, M
AU  - Ziemer M
AD  - Klinik fur Dermatologie, Venerologie und Allergologie, Universitat Leipzig, 
      Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland, 
      mirjana.ziemer@medizin.uni-leipzig.de.
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Kutane Arzneimittelreaktionen vom Spattyp. Pathogenese, Klinik und Histologie.
PL  - Germany
TA  - Hautarzt
JT  - Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete
JID - 0372755
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Dermatitis, Allergic Contact/classification/*immunology/*pathology
MH  - Diagnosis, Differential
MH  - Drug Eruptions/classification/*immunology/*pathology
MH  - Humans
MH  - Immunoglobulin E/*immunology
MH  - Skin/*drug effects/*immunology
EDAT- 2014/05/14 06:00
MHDA- 2015/04/10 06:00
CRDT- 2014/05/14 06:00
PHST- 2014/05/14 06:00 [entrez]
PHST- 2014/05/14 06:00 [pubmed]
PHST- 2015/04/10 06:00 [medline]
AID - 10.1007/s00105-013-2696-9 [doi]
PST - ppublish
SO  - Hautarzt. 2014 May;65(5):397-408. doi: 10.1007/s00105-013-2696-9.