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What Is the Pathogenesis?

John R. Sullivan, MB, BS, FACD; Neil H. Shear, MD, FRCPC

Arch Dermatol. 2001;137:357-364.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Drug hypersensitivity syndrome (DHS) is a severe idiosyncratic reaction associated with drug therapy. Cutaneous eruptions are the most common idiosyncratic reaction to drugs, but DHS is not just a drug-related eruption. We defined DHS by the clinical triad of fever, rash, and internal organ involvement.¹ The pathogenesis of this disease is not well defined; however, intriguing clinical and laboratory observations and associations provide insight into the mechanistic puzzle of this iatrogenic disease. The article in this issue by Descamps et al² raises further questions as to this syndrome's association with viral infection. Understanding the pathomechanism of DHS is important for the prevention and improved management of these potentially life-threatening reactions.

Drug hypersensitivity syndrome only occurs in a relatively small proportion of patients but is associated with considerable morbidity and mortality. The unpredictability and potential severity of this reaction make . . . [Full Text of this Article]

THE PATHOGENESIS OF DHS

What Is the Mechanism of "Drug Rashes"?

What Have We Learned About the Pathogenesis of DHS?

The Drug, Drug-Dosage, Drug Metabolites, Drug-Drug Interactions, and Pharmacogenetics

How Do Reactive Drug Products Cause an Adaptive Immune Response?

Virus-Drug Interactions

Human Immunodeficiency Virus

Human Herpesviruses

THE IMMUNOLOGY AND MOLECULAR BIOLOGY OF DHS

THE CONCEPT OF PATHOGENESIS AND UNEXPECTED REACTIONS TO DRUGS

A MULTIFACTORIAL MODEL OF THE PATHOGENESIS OF DHS

CONCLUSIONS

From the Divisions of Clinical Pharmacology and Dermatology, Departments of Pharmacology and Medicine, University of Toronto Medical School, Toronto, Ontario.

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