Delayed-type hypersensitivity to oral and parenteral drugs

J Dtsch Dermatol Ges. 2017 Nov;15(11):1111-1132. doi: 10.1111/ddg.13362.

Abstract

Adverse drug reactions of the delayed type rank among the most common dermatoses and are predominantly characterized by exanthematous macular or maculopapular eruptions. However, approximately 2 % of affected individuals develop severe or even life-threatening systemic immune reactions associated with organ involvement, requiring immediate diagnosis and treatment. Numerous drugs are capable of eliciting delayed-type hypersensitivity reactions, with antibiotics, anticonvulsant drugs, and the xanthine oxidase inhibitor allopurinol being the most common. Apart from genetic susceptibility, predisposing factors for the development of drug hypersensitivity reactions include high drug doses, polypharmacy, long treatment duration, female gender, as well as acute or chronic infections.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Adrenal Cortex Hormones / therapeutic use
  • Drug Eruptions / diagnosis*
  • Drug Eruptions / drug therapy
  • Drug Eruptions / immunology
  • Humans
  • Hypersensitivity, Delayed / chemically induced*
  • Hypersensitivity, Delayed / drug therapy
  • Hypersensitivity, Delayed / immunology
  • Hypersensitivity, Immediate / chemically induced
  • Hypersensitivity, Immediate / drug therapy
  • Hypersensitivity, Immediate / immunology
  • Infusions, Parenteral
  • Intradermal Tests
  • Patch Tests
  • Prescription Drugs / administration & dosage
  • Prescription Drugs / adverse effects*
  • Risk Factors
  • Virus Diseases / complications
  • Virus Diseases / immunology

Substances

  • Adrenal Cortex Hormones
  • Prescription Drugs