title: Diagnostic approach to drug allergy.
abstract: The approach to drug hypersensitivity always comprises a clinical and a diagnostic workup. About 15% of drug side effects are due to hypersensitivity reactions. All types of immunological reactions can be induced by drugs, but type I and type IV reactions are seen most often. The initial judgment of the skin symptoms is therefore one of the key factors besides a stringent history of drug intake for a further diagnostic workup. The goal of a diagnostic workup is not only to identify the culprit drug, but also to defer the patient from similar drugs in order to prevent a second episode. In the case of missing alternatives and unidentified drug sensitivity, reexposure to the previous drug must be discussed; however, in severe cutaneous reactions this should generally be avoided.
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. th.harr@gmail.com
authors.forename: Thomas
authors.initials: T
authors.lastname: Harr
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000175:diagnosis; D000970:Antineoplastic Agents / Q000009:adverse effects; D001491:Basophils / Q000276:immunology; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005079:Excipients / Q000009:adverse effects; D005434:Flow Cytometry; D006801:Humans; D007428:Intradermal Tests; D007455:Iodine / Q000009:adverse effects; D008213:Lymphocyte Activation; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D010328:Patch Tests; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis; D047090:beta-Lactams / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D005079:Excipients; D009466:Neuromuscular Blocking Agents; D047090:beta-Lactams; D007455:Iodine