| Abstract [eng] |
Drug-induced skin hypersensitivity reactions are classified as a subset of adverse drug reactions, categorized into Type A (predictable) and Type B (unpredictable) reactions. Type B reactions encompass drug allergy, which presents the focus of this thesis, and non-immunological drug hypersensitivity, further subdivided into drug intolerance, drug idiosyncrasy and pseudo-allergies. Cutaneous adverse drug reactions are the most common adverse drug reactions, affecting 45% of cases. They can range from mild to severe manifestations like morbilliform eruptions, urticarial toxidermia, fixed pigmented erythema, toxic epidermal necrolysis and acute generalized exanthematous pustulosis. The key principle of the diagnosis of drug-induced skin hypersensitivity reactions involves a detailed patient history, the chronology of reactions, and the physical examination. Various diagnostic tools are employed, including drug provocation tests, skin tests (skin prick, intradermal, patch tests), and in vitro tests (lymphocyte transformation, basophil activation, Enzyme-linked ImmunoSpot assays). Laboratory investigations support diagnosis and monitoring, but results may not always confirm drug-induced reactions conclusively. Treatment involves discontinuation of the offending drug and supportive care tailored to reaction severity. Mild to moderate reactions may be managed with antihistamines, nonsteroidal anti-inflammatory drugs, or topical corticosteroids. Severe cases may require systemic steroids or immunosuppressive agents, with hospitalization warranted for specific signs of severity. |
