title: Cutaneous adverse drug reactions to anti-tuberculosis drugs: state of the art and into the future.
abstract: First- and second-line anti-tuberculosis drugs are associated with a diverse presentation of cutaneous adverse drug reactions (CADR), ranging from mild to life threatening. An individual drug can cause multiple types of CADR, and a specific type of CADR can be due to any anti-tuberculosis drug, which can make the management of tuberculosis (TB) following CADR challenging. The higher incidence of TB and CADR in HIV-infected persons makes TB-associated CADR a burgeoning problem for clinicians, particularly in high HIV-prevalence settings. This review discusses the pathogenesis, epidemiology, clinical presentation, diagnosis and management of TB-associated CADR. Clinical controversies including its impact on treatment outcomes, challenges in restarting optimal anti-tuberculosis therapy and the timing of highly active antiretroviral therapy initiation in those with HIV coinfection are also discussed. Finally, gaps in the current knowledge of TB-associated CADR have been identified and a research agenda has been proposed.
authors.affiliation: Division of Dermatology, Department of Medicine, University of Cape Town, Western Cape, South Africa.
authors.forename: Rannakoe J
authors.initials: RJ
authors.lastname: Lehloenya
authors.forename: Keertan
authors.initials: K
authors.lastname: Dheda
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015658:HIV Infections / Q000150:complications; D006801:Humans; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents