title: Management of nonimmediate hypersensitivity reactions to drugs.
abstract: Nonimmediate hypersensitivity to drugs has a huge diversity of clinical presentations affecting exclusively or predominantly a single organ (most often the skin) or multiple organs. The latter is the rule with drug reaction with eosinophilia and systemic symptoms, and with drug-induced vasculitis. The management includes a dozen successive steps. Finally, the patient should be provided clear information on the suspected cause of the reaction, recommendations for follow-up after severe reactions associated with a risk of sequelae, and clear recommendations for future use of medications. Pharmacovigilance networks should be informed.
authors.affiliation: Université Paris-Est Créteil, France; RegiSCAR Network. Electronic address: jean-claude.roujeau@wanadoo.fr.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Roujeau
authors.affiliation: RegiSCAR Network; Reference Center for Blistering Diseases, Hôpital Henri Mondor, Créteil, France.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Haddad
authors.affiliation: RegiSCAR Network; Department of Dermatology, Dokumentationszentrum schwerer Hautreaktionen (dZh), Medical Center-University of Freiburg, Hauptstr 7, Freiburg 79104, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Paulmann
authors.affiliation: RegiSCAR Network; Department of Dermatology, Dokumentationszentrum schwerer Hautreaktionen (dZh), Medical Center-University of Freiburg, Hauptstr 7, Freiburg 79104, Germany.
authors.forename: Maja
authors.initials: M
authors.lastname: Mockenhaupt
mesh_terms: D019468:Disease Management; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D060735:Pharmacovigilance; D012720:Severity of Illness Index
keywords: Drug reaction with eosinophilia and systemic symptoms (DRESS); Drug-allergic liver injury (DALI); Drug-induced nephritis (DIN); Drug-induced vasculitis; Stevens-Johnson syndrome (SJS); Toxic epidermal necrolysis (TEN)