PMID- 37793359
OWN - NLM
STAT- MEDLINE
DCOM- 20231207
LR  - 20231217
IS  - 1421-9832 (Electronic)
IS  - 1018-8665 (Print)
IS  - 1018-8665 (Linking)
VI  - 239
IP  - 6
DP  - 2023
TI  - Genotypic and Phenotypic Characteristics of Co-Trimoxazole-Induced Cutaneous 
      Adverse Reactions.
PG  - 966-975
LID - 10.1159/000534342 [doi]
AB  - BACKGROUND: Co-trimoxazole has been reported as a common culprit drug for various 
      cutaneous adverse drug reactions (CADRs). However, information on genotypic and 
      phenotypic characteristics is still limited. We aimed to study clinical 
      characteristics, genetic suitability, laboratory findings, and treatment outcomes 
      in patients with co-trimoxazole-induced CADR and determine variables associated 
      with severe cutaneous adverse reactions (SCARs). METHODS: The medical records of 
      all patients diagnosed with co-trimoxazole-induced CADR during October 2015 and 
      October 2021 were reviewed. Clinical characteristics and laboratory investigation 
      with an emphasis on human leukocyte antigen (HLA) class I and HLA-DRB1 results 
      linked to subtypes of cutaneous adverse reactions were evaluated. RESULTS: 
      Seventy-two patients diagnosed with co-trimoxazole-induced CADR were included in 
      the study. Mean age at diagnosis was 38.0 +/- 14.6 years old, and 72% were female. 
      Subtypes of reactions included maculopapular eruption (MPE; 56.9%), drug reaction 
      with eosinophilia and systemic symptoms (DRESS; 23.6%), Stevens-Johnson syndrome 
      (SJS; 12.5%), fixed drug eruption (4.2%), and urticaria (2.8%). Characteristics 
      that were significantly associated with SCARs included male gender (OR = 3.01, 
      95% CI: 1.04-8.75), HIV infection (OR = 3.48, 95% CI: 1.13-10.75), prophylactic 
      use of co-trimoxazole (OR = 4.89, 95% CI: 1.54-15.57), and co-trimoxazole 
      administration longer than 10 days (OR = 7.65, 95% CI: 2.57-22.78). HLA-B*38:02 
      was associated with co-trimoxazole-induced SJS, while HLA-A*11:01, HLA-B*13:01, 
      and HLA-DRB1*12:01 were associated with co-trimoxazole-induced DRESS. HLA-B*52:01 
      was associated with co-trimoxazole-induced MPE. CONCLUSIONS: Co-trimoxazole could 
      induce various phenotypes of CADRs. Genotypic and phenotypic factors that may 
      potentially predict co-trimoxazole-induced SCARs include male gender, HIV 
      infection, prophylactic and prolonged drug use, as well as the presence of 
      HLA-A*11:01, HLA-B*13:01, HLA-B*38:02, or HLA-DRB1*12:01 alleles.
CI  - (c) 2023 The Author(s). Published by S. Karger AG, Basel.
FAU - Iamsumang, Wimolsiri
AU  - Iamsumang W
AD  - Division of Dermatology, Department of Internal Medicine, Faculty of Medicine 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Chanprapaph, Kumutnart
AU  - Chanprapaph K
AD  - Division of Dermatology, Department of Internal Medicine, Faculty of Medicine 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Sukasem, Chonlaphat
AU  - Sukasem C
AD  - Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, 
      Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Satapornpong, Patompong
AU  - Satapornpong P
AD  - Division of General Pharmacy Practice, Department of Pharmaceutical Care, College 
      of Pharmacy, Rangsit University, Lak Hok, Thailand.
AD  - Excellence Pharmacogenomics and Precision Medicine Centre, College of Pharmacy, 
      Rangsit University, Lak Hok, Thailand.
FAU - Thadanipon, Kunlawat
AU  - Thadanipon K
AD  - Division of Dermatology, Department of Internal Medicine, Faculty of Medicine 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Suchonwanit, Poonkiat
AU  - Suchonwanit P
AD  - Division of Dermatology, Department of Internal Medicine, Faculty of Medicine 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Jantararoungtong, Thawinee
AU  - Jantararoungtong T
AD  - Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, 
      Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Anuntrangsee, Tanaporn
AU  - Anuntrangsee T
AD  - Division of Dermatology, Department of Internal Medicine, Faculty of Medicine 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
LA  - eng
PT  - Journal Article
DEP - 20231004
PL  - Switzerland
TA  - Dermatology
JT  - Dermatology (Basel, Switzerland)
JID - 9203244
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
RN  - 0 (HLA-DRB1 Chains)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-A Antigens)
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - Young Adult
MH  - Adult
MH  - Middle Aged
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects
MH  - *HIV Infections
MH  - HLA-DRB1 Chains/genetics
MH  - Cicatrix
MH  - HLA-B Antigens/genetics
MH  - *Stevens-Johnson Syndrome/genetics
MH  - HLA-A Antigens/genetics
MH  - Phenotype
PMC - PMC10711762
OTO - NOTNLM
OT  - Co-trimoxazole
OT  - Drug reaction with eosinophilia and systemic symptoms
OT  - Human leukocyte antigens
OT  - Severe cutaneous adverse reactions
OT  - Stevens-Johnson syndrome
COIS- The authors have no conflicts of interest to declare.
EDAT- 2023/10/05 01:00
MHDA- 2023/12/07 12:43
PMCR- 2023/10/04
CRDT- 2023/10/04 18:23
PHST- 2022/11/26 00:00 [received]
PHST- 2023/09/25 00:00 [accepted]
PHST- 2023/12/07 12:43 [medline]
PHST- 2023/10/05 01:00 [pubmed]
PHST- 2023/10/04 18:23 [entrez]
PHST- 2023/10/04 00:00 [pmc-release]
AID - 000534342 [pii]
AID - 534342 [pii]
AID - 10.1159/000534342 [doi]
PST - ppublish
SO  - Dermatology. 2023;239(6):966-975. doi: 10.1159/000534342. Epub 2023 Oct 4.