Drug skin metabolites and allergic drug reactions.
OBJECTIVE
Presentation of recent studies about xenobiotica metabolism of the skin and its impact on drug-allergic reactions.


RESULTS
The skin possesses not only multiple cytochrome P450 isoenzymes but also influx and efflux transporter proteins. The pattern of cytochrome P450 isoenzymes in the skin differs from the pattern in the liver. Studies on the role of this metabolism in drug-induced hypersensitivity have mainly focused on sulphonamides, anticonvulsants, diclofenac and nevirapine. Studies with the contact sensitizer carvoxime provided evidence for the decisive role of xenobiotica metabolism in antigen-presenting cells.


CONCLUSIONS
The skin is a major target organ for allergic drug reactions that may be explained by its different barrier functions including immune system and the armamentarium of xenobiotica-metabolizing enzymes.
Merk
Hans F
HF
Department of Dermatology and Allergology,University Hospital, RWTH Aachen University, Pauwelsstrasse 30, Aachen D-52074, Germany. hans.merk@post.rwth-aachen.de
D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects; D017951:Antigen Presentation; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D017449:Dermatitis, Allergic Contact / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D004008:Diclofenac / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D020869:Gene Expression Profiling; D006241:Haptens / Q000276:immunology; D006801:Humans; D007801:Langerhans Cells / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D019829:Nevirapine / Q000009:adverse effects; D012867:Skin / Q000187:drug effects / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D013449:Sulfonamides / Q000009:adverse effects; D015262:Xenobiotics / Q000009:adverse effects*
D000927:Anticonvulsants; D006241:Haptens; D013449:Sulfonamides; D015262:Xenobiotics; D004008:Diclofenac; D003577:Cytochrome P-450 Enzyme System; D019829:Nevirapine