Ikediobi Ogechi, Schneider Jeremy A
Department of Dermatology, University of California, San Diego, CA 92093, USA.
J Pers Med. 2021 Jan 26;11(2):71. doi: 10.3390/jpm11020071.
Severe cutaneous adverse drug reactions (SCAR) such as the Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and drug rash with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DIHS) can be induced by a plethora of medications. The field of pharmacogenomics aims to prevent severe adverse drug reactions by using our knowledge of the inherited or acquired genetic risk of drug metabolizing enzymes, drug targets, or the human leukocyte antigen (HLA) genotype. Dermatologists are experts in the diagnosis and management of severe cutaneous adverse drug reactions (SCAR) in both the inpatient and outpatient setting. However, most dermatologists in the US have not focused on the prevention of SCAR. Therefore, this paper presents a case series and review of the literature highlighting salient examples of how dermatologists can apply pharmacogenomics in the diagnosis and especially in the prevention of SCAR induced by allopurinol and sulfamethoxazole/trimethoprim, two commonly prescribed medications.
严重皮肤药物不良反应（SCAR），如史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症（SJS/TEN）以及伴有嗜酸性粒细胞增多和全身症状的药疹/药物性超敏反应综合征（DIHS），可由多种药物诱发。药物基因组学领域旨在通过运用我们对药物代谢酶、药物靶点或人类白细胞抗原（HLA）基因型的遗传或获得性遗传风险的了解，来预防严重药物不良反应。皮肤科医生是住院和门诊环境中严重皮肤药物不良反应（SCAR）诊断和管理方面的专家。然而，美国大多数皮肤科医生尚未专注于SCAR的预防。因此，本文呈现了一个病例系列并对文献进行综述，重点介绍了皮肤科医生如何将药物基因组学应用于诊断，尤其是预防由别嘌醇和磺胺甲恶唑/甲氧苄啶这两种常用处方药诱发的SCAR的显著实例。
