Drug hypersensitivity reactions are interactions between a pharmacological agent and the human immune system, and can manifest as a heterogeneous clinical spectrum depending on the underlying pathophysiological and immunological mechanisms . When drug hypersensitivity reactions are mediated by specific immunological mechanisms, they are referred to as drug allergy . Among adverse reactions to drugs, allergic reactions to β‐lactams are the most common .Depending on the time interval between drug exposure and onset of the reaction, as well as the underlying immunological mechanisms, allergic hypersensitivity reactions are classified as immediate and non‐immediate . Immediate reactions usually occur within 30–60 min after the last intake. They clinically manifest with urticaria and/or angioedema, rhinitis, bronchospasm, and anaphylactic shock . Non‐immediate reactions occur later than 1 h after the last drug intake, usually last for several days, and are regarded as being T cell‐mediated . They commonly manifest with delayed maculopapular exanthema, but also with more severe reactions, such as generalized bullous fixed drug eruption (GBFDE), acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome (SJS), or toxic epidermal necrolysis (TEN) .The diagnosis of drug hypersensitivity includes a stepwise approach. First, a detailed medical history is taken, including the
Contact Dermatitis – Wiley
Published: Jan 1, 2018
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