Recognizing Drug Hypersensitivity in Pigmented Skin - 23/04/22

Doi : 10.1016/j.iac.2022.01.005

Rannakoe J. Lehloenya, MD, FCDerm (SA) ^a,^b,^⁎ , Elizabeth J. Phillips, MD ^c,^d, Helena B. Pasieka, MD, MS ^e,^f,^g,^h, Jonny Peter, MD, PhD ^b,^i,^j
^a Division of Dermatology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Dermatology ward G23, New Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa
^b Combined Drug Allergy Clinic, Groote Schuur Hospital, Dermatology ward G23, New Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa
^c Center for Drug Safety & Immunology, Vanderbilt University Medical Center, Nashville, TN
^d Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
^e Department of Dermatology, Uniformed Serviced University, Bethesda, MD, USA
^f Department of Medicine, Uniformed Serviced University, Bethesda, MD, USA
^g Department of Dermatology, MedStar Washington Hospital Center/Georgetown University Hospital, Washington, DC, USA
^h The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA
ⁱ Division of Allergy and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town Lung institute, George Street, Mowbray, 7925, Cape Town, South Africa
^j Allergy and Immunology Unit, University of Cape Town Lung Institute, Old Main Building, Groote Schuur Hospital, Anzio Road, 7925, Cape Town, South Africa

^∗Corresponding author. Dermatology ward G23, New Groote Schuur Hospital, Observatory, Cape Town 7925.Dermatology ward G23New Groote Schuur HospitalObservatoryCape Town7925

Résumé

The imagery of pigmented skin is underrepresented in teaching materials such as textbooks, journals, and online references, and this has resulted in poorer diagnostic and management outcomes of skin pathology, including delayed cutaneous drug hypersensitivity reactions. In this review, we use clinical images to highlight factors that impact clinical presentations and sequelae of drug hypersensitivity reactions in pigmented skin compared with nonpigmented skin. We describe clinical features in some anatomic sites that aid diagnosis or are associated with more severe sequelae. Finally, we discuss strategies that may aid the diagnosis and management of these reactions in pigmented skin.

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Keywords : Drug hypersensitivity reactions, Pigmented skin, Clinical presentation, Sequelae

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Funding: R.J. Lehloenya is supported by South African Medical Research Council and nonrated researcher support from the South African National Research Foundation.

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Vol 42 - N° 2

P. 219-238 - mai 2022 Retour au numéro

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Drug Hypersensitivity: A Glass Half Full
Elizabeth J. Phillips

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Recognizing Drug Hypersensitivity in Pigmented Skin - 23/04/22

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