title: Recent advances in the understanding of severe cutaneous adverse reactions.
abstract: Severe cutaneous adverse reactions (SCARs) encompass a heterogeneous group of delayed hypersensitivity reactions, which are most frequently caused by drugs. Our understanding of several aspects of SCAR syndromes has evolved considerably over the last decade. This review explores evolving knowledge of the immunopathogenic mechanisms, pharmacogenomic associations, in vivo and ex vivo diagnostics for causality assessment, and medication cross-reactivity data related to SCAR syndromes. Given the rarity and severity of these diseases, multidisciplinary collaboration through large international, national and/or multicentre networks to collect prospective data on patients with SCAR syndromes should be prioritized. This will further enhance a systematized framework for translating epidemiological, clinical and immunopathogenetic advances into preventive efforts and improved outcomes for patients.
authors.affiliation: School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: N R
authors.identifier: http://orcid.org/0000-0002-7972-9050
authors.initials: NR
authors.lastname: Adler
authors.affiliation: School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: A K
authors.initials: AK
authors.lastname: Aung
authors.affiliation: Department of Dermatology, University of Alabama, Birmingham, AL, U.S.A.
authors.forename: E N
authors.initials: EN
authors.lastname: Ergen
authors.affiliation: Austin Health, Melbourne, Victoria, Australia.|The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Trubiano
authors.affiliation: Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: M S Y
authors.initials: MSY
authors.lastname: Goh
authors.affiliation: Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia.|Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN, U.S.A.
authors.forename: E J
authors.initials: EJ
authors.lastname: Phillips
mesh_terms: D000493:Allopurinol / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D002220:Carbamazepine / Q000009:adverse effects; D002511:Cephalosporins / Q000009:adverse effects; D015224:Dideoxynucleosides / Q000009:adverse effects; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D004347:Drug Interactions; D006566:Herpesviridae Infections / Q000139:chemically induced; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology; D010597:Pharmacogenetics / Q000639:trends; D011446:Prospective Studies; D012882:Skin Tests / Q000379:methods; D013601:T-Lymphocytes / Q000276:immunology; D014775:Virus Activation / Q000187:drug effects; D017735:Virus Latency / Q000187:drug effects; D047090:beta-Lactams / Q000009:adverse effects; D000099227:Abacavir
chemical_list: D000493:Allopurinol; D000927:Anticonvulsants; D002220:Carbamazepine; D002511:Cephalosporins; D015224:Dideoxynucleosides; D047090:beta-Lactams; D000099227:Abacavir