SEVERE DRUG-INDUCED SKIN REACTIONS: A SYSTEMATIC REVIEW OF PREDICTORS, MANAGEMENT, AND PROGNOSIS
DOI:
https://doi.org/10.56238/levv17n59-020Keywords:
Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Drug Hypersensitivity Syndrome, PharmacovigilanceAbstract
Introduction: Severe drug-induced skin reactions, including Stevens–Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms, are rare but potentially life-threatening conditions associated with significant morbidity and long-term sequelae. Advances in immunopathology, pharmacogenomics, and supportive care have improved understanding, yet optimal management strategies and prognostic tools remain heterogeneous across clinical settings.
Objective: To systematically evaluate predictors, management strategies, and prognostic factors associated with severe drug-induced skin reactions, with additional focus on biomarkers, therapeutic interventions, and long-term outcomes.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP, including studies published within the last five years, with extension to ten years if necessary. Inclusion criteria comprised original studies involving human subjects evaluating predictors, treatment, or prognosis, with no language restriction. Independent reviewers performed study selection, data extraction, and risk of bias assessment using validated tools, and certainty of evidence was evaluated using the GRADE approach.
Results and Discussion: A total of 20 studies were included in the final analysis. The evidence demonstrated that severe drug-induced skin reactions are associated with diverse clinical phenotypes, significant treatment variability, and important long-term complications such as chronic pain, ocular damage, and increased cardiovascular risk.
Conclusion: Severe drug-induced skin reactions require early recognition, prompt drug withdrawal, and multidisciplinary management to optimize outcomes. Advances in biomarker identification and personalized medicine offer promising avenues for improved prognostication and prevention. Further high-quality studies are needed to standardize treatment protocols and refine risk stratification.
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