Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou, Taiwan.
Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Clin Pharmacol Ther. 2017 Jul;102(1):86-97. doi: 10.1002/cpt.683. Epub 2017 Jun 3.
Cutaneous idiosyncratic drug reactions (CIDRs) are usually unpredictable, ranging from mild maculopapular exanthema (MPE) to severe cutaneous adverse drug reactions (SCARs) such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Increasing evidence suggests that HLA alleles are strongly associated with drug-induced-CIDRs. The pathomechanisms for CIDRs include genetic polymorphisms affecting complex immune-specific HLA/drug antigen/T-cell receptor interactions and drug metabolism. Pharmacogenomic tests to prevent CIDRs have been widely implemented in clinical practice in recent years.
皮肤药物不良反应（CIDR）通常是不可预测的，从轻度斑丘疹（MPE）到严重的皮肤药物不良反应（SCAR），如药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）、史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）。越来越多的证据表明，HLA 等位基因与药物引起的 CIDR 密切相关。CIDR 的发病机制包括影响复杂免疫特异性 HLA/药物抗原/T 细胞受体相互作用和药物代谢的遗传多态性。近年来，预防 CIDR 的药物基因组学检测已在临床实践中广泛实施。
