Cadot Romane, Gery Perrine, Lenief Vanina, Nicolas Jean-François, Vocanson Marc, Tauber Marie
CIRI-Centre International de Recherche en Infectiologie, Lyon, France.
INSERM, U1111, Lyon, France.
Allergy. 2025 Jan;80(1):47-62. doi: 10.1111/all.16316. Epub 2024 Sep 18.
Severe cutaneous adverse reactions to drugs (SCARs) are rare but life-threatening delayed allergies. While they primarily affect the skin, they can also affect internal organs. Accordingly, they present with diverse clinical symptoms that vary not only between SCARs subtypes but also among patients. Despite the availability of topical and systemic treatments, these only address the symptoms and not the cause. To develop more effective therapies, it is necessary to elucidate the complexity of the pathophysiology of SCARs in relation to their severity. In line with the new type IV hypersensitivity reactions nomenclature proposed by the European Academy of Allergy and Clinical Immunology (EAACI), this review highlights the current insights into the intricate immune mechanisms engaged, the interplay between the culprit drug and genetic predisposition in drug presentation mechanisms, but also how external factors, such as viruses, are implicated in SCARs. Their relevance to the development of targeted medicine is also discussed.
药物引起的严重皮肤不良反应（SCARs）虽罕见，但却是危及生命的迟发性过敏反应。它们主要影响皮肤，但也可能累及内脏器官。因此，其临床表现多样，不仅在SCARs亚型之间存在差异，在患者个体之间也有所不同。尽管有局部和全身治疗方法，但这些仅能缓解症状，无法解决病因。为了开发更有效的治疗方法，有必要阐明SCARs病理生理学复杂性与其严重程度之间的关系。根据欧洲变态反应和临床免疫学会（EAACI）提出的新型IV型超敏反应命名法，本综述重点介绍了目前对所涉及的复杂免疫机制、致病药物与药物呈现机制中遗传易感性之间的相互作用的见解，以及病毒等外部因素如何与SCARs相关联。还讨论了它们与靶向药物开发的相关性。
