Search
pharmaceutical agents causing severe cutaneous adverse reactions (SCARs)
Risk of developing SCAR is greatest during 1st few weeks of therapy
Etiology:
1) antibiotics:
- sulfonamides
- nalidixic acid
- penicillins
2) anticonvulsants:
- carbamazepine#
- phenytoin#
- phenobarbital
- lamotrigine
3) anvirals
- nevirapine
3) other
- allopurinol (esp doses > 200 mg/day)*
- oxicam NSAIDs (phenylbutazone)
- tramadol
- pantoprozole
- sertraline
- bromides, iodides
- chlormezanone
- sulfasalazine
* allopurinol most common cause of SCARs in Europe
# drug-induced Stevens-Johnson syndrome & toxic epidermal necrolysis (carbamazepine, phenytoin) linked to HLA-B*1502 in Han Chinese (Asians, South Asian Indians)
References
- Mockenhaupt et al,
Stevens-Johnson syndrome and toxic epidermal necrolysis:
Assessment of medication risks with emphasis on recently
marketed drugs: The EuroSCAR-study
J invest Dermatol 2008, 129:35
PMID: 17805350
- Halevy S et al,
Allopurinol is the most common cause of Stevens-Johnson
syndrome and toxic epidermal necrolysis in Europe and Israel
J Am Acad Dermatol 2008, 58:25
- Mustafa SS, Ostrov D, Yerly D.
Severe cutaneous adverse drug reactions: presentation, risk factors, and management.
Curr Allergy Asthma Rep. 2018;18:26.
PMID: 29574562