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Controversies in the Management of Cutaneous Adverse Drug Reactions
Some cutaneous adverse drug reactions (CADRs) are severe life-threatening conditions due to multisystem involvements with a high morbidity and mortality rates ranging from 25 - 70% and require immediate medical care. But there are huge controversies regarding the management because large clinical tr...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903041/ https://www.ncbi.nlm.nih.gov/pubmed/29692453 http://dx.doi.org/10.4103/ijd.IJD_585_17 |
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author | Manchanda, Yashpal Das, Sudip Sarda, Aarti Biswas, Projna |
author_facet | Manchanda, Yashpal Das, Sudip Sarda, Aarti Biswas, Projna |
author_sort | Manchanda, Yashpal |
collection | PubMed |
description | Some cutaneous adverse drug reactions (CADRs) are severe life-threatening conditions due to multisystem involvements with a high morbidity and mortality rates ranging from 25 - 70% and require immediate medical care. But there are huge controversies regarding the management because large clinical trials are lacking. Most frequent discussion and division occur regarding the use of systemic corticosteroid as early intervention with corticosteroids controls inflammation. Corticosteroids are potent agents that target several intracellular processes to modify almost all components of inflammatory and immune responses but their impact on the long term disease course is not known. Controlled relapses of rash and hepatitis may occur as corticosteroids are tapered. A chronic HHV6 activation promoted by systemic steroids could explain these relapses. Second important issue is the use of antitubercular drugs (ATD) in case of CADR due to multidrug therapy of ATD. As both the tuberculosis and CADR are life threatening conditions and we can not spare treatment of tuberculosis for CADR, we should come to a conclusion which is not yet decided. In the same way the use of antileprotic MDT in CADR due to MDT raises a similar controversy. So, here we focus on those controversies and discuss the issues. |
format | Online Article Text |
id | pubmed-5903041 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-59030412018-04-24 Controversies in the Management of Cutaneous Adverse Drug Reactions Manchanda, Yashpal Das, Sudip Sarda, Aarti Biswas, Projna Indian J Dermatol IJD Symposium Some cutaneous adverse drug reactions (CADRs) are severe life-threatening conditions due to multisystem involvements with a high morbidity and mortality rates ranging from 25 - 70% and require immediate medical care. But there are huge controversies regarding the management because large clinical trials are lacking. Most frequent discussion and division occur regarding the use of systemic corticosteroid as early intervention with corticosteroids controls inflammation. Corticosteroids are potent agents that target several intracellular processes to modify almost all components of inflammatory and immune responses but their impact on the long term disease course is not known. Controlled relapses of rash and hepatitis may occur as corticosteroids are tapered. A chronic HHV6 activation promoted by systemic steroids could explain these relapses. Second important issue is the use of antitubercular drugs (ATD) in case of CADR due to multidrug therapy of ATD. As both the tuberculosis and CADR are life threatening conditions and we can not spare treatment of tuberculosis for CADR, we should come to a conclusion which is not yet decided. In the same way the use of antileprotic MDT in CADR due to MDT raises a similar controversy. So, here we focus on those controversies and discuss the issues. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5903041/ /pubmed/29692453 http://dx.doi.org/10.4103/ijd.IJD_585_17 Text en Copyright: © Indian Journal of Dermatology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | IJD Symposium Manchanda, Yashpal Das, Sudip Sarda, Aarti Biswas, Projna Controversies in the Management of Cutaneous Adverse Drug Reactions |
title | Controversies in the Management of Cutaneous Adverse Drug Reactions |
title_full | Controversies in the Management of Cutaneous Adverse Drug Reactions |
title_fullStr | Controversies in the Management of Cutaneous Adverse Drug Reactions |
title_full_unstemmed | Controversies in the Management of Cutaneous Adverse Drug Reactions |
title_short | Controversies in the Management of Cutaneous Adverse Drug Reactions |
title_sort | controversies in the management of cutaneous adverse drug reactions |
topic | IJD Symposium |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903041/ https://www.ncbi.nlm.nih.gov/pubmed/29692453 http://dx.doi.org/10.4103/ijd.IJD_585_17 |
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