title: Cutaneous symptoms in drug allergy: what have we learnt?
abstract: OBJECTIVE
  A number of studies over recent years have shown the relevance of nonimmediate immunological reactions to drugs and emphasized the need for these reactions to be studied in greater depth, including both in-vivo and in-vitro tests and provocation studies.
  
  
  RESULTS
  Several clinical entities are involved, ranging from mild to severe reactions. Nonimmediate reactions have a special tropism for the skin, although other organspecific or systemic reactions may also occur. In the affected organ, the drug acts as a hapten or protohapten, originating an immunological stimulus that is followed by recruitment of T lymphocytes and other types of cells, depending on the reaction. This involves a trafficking phenomenon in which these cells use different receptors that interplay with their corresponding ligands in the tissue. In addition, a number of activation and cytotoxic markers are also expressed, which are related with disease severity.
  
  
  CONCLUSIONS
  Current studies provide overwhelming evidence of the interaction between the organ involved, very often the skin, and immunocompetent cells. This is of relevance for diagnostic and therapeutic approaches.
authors.affiliation: Research Laboratory, Fundacion IMABIS-Carlos Haya Hospital, Spain.
authors.forename: Cristobalina
authors.initials: C
authors.lastname: Mayorga
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Torres
authors.forename: Javier
authors.initials: J
authors.lastname: Fernandez
authors.forename: Gabriela
authors.initials: G
authors.lastname: Canto
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanca
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D002450:Cell Communication / Q000276:immunology*; D002465:Cell Movement; D003601:Cytotoxicity Tests, Immunologic; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D012867:Skin / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology* / Q000378:metabolism / Q000473:pathology
chemical_list: D015415:Biomarkers