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Viral Infections and Cutaneous Drug-Related Eruptions

Eleonora Anci1, Camille Braun1,2, Annalisa Marinosci1

  • 1Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.

Frontiers in Pharmacology
|March 29, 2021
PubMed

Insights

Many children experience skin reactions to antibiotics, but few have true allergies. Viruses, like enterovirus and EBV, often cause these reactions, sometimes triggering drug hypersensitivity responses.

Area of Science:

  • Immunology
  • Dermatology
  • Virology

Background:

  • Cutaneous adverse drug reactions (cADRs) affect up to 10% of children on antibiotics, with confirmed allergy in less than 20%.
  • Non-allergic cADRs are frequently linked to viral infections (e.g., enterovirus, Epstein-Barr Virus [EBV]), which can induce skin manifestations.
  • Viruses may predispose individuals to drug hypersensitivity reactions (DHRs) by modulating immune responses, with antibiotics acting as triggers.

Purpose of the Study:

  • To review the current understanding of viruses' roles in various types of drug hypersensitivity reactions (DHRs).
  • To explore the mechanisms underlying virus- and drug-induced skin reactions.
  • To inform clinical practice and patient care regarding DHRs and viral co-infections.

Main Methods:

  • Literature review of existing studies on viral infections and drug hypersensitivity.
  • Analysis of immunological and dermatological mechanisms involved in cADRs.
  • Synthesis of current knowledge on the interplay between viruses and DHRs.

Main Results:

  • Viruses are implicated in a significant proportion of non-allergic cutaneous adverse drug reactions in children.
  • Viral infections can potentiate immune responses, increasing susceptibility to antibiotic-triggered DHRs.
  • Herpes viruses are particularly noted to play a role in severe DHRs like DRESS syndrome.

Conclusions:

  • Understanding the complex interplay between viral infections and DHRs is crucial for accurate diagnosis and management.
  • Further research is needed to elucidate the precise mechanisms linking viruses and DHRs.
  • Improved knowledge will enhance clinical decision-making and patient care for DHRs.

Keywords:
allergydrughypersensitivitymechanismvirus

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