[Cutaneous reactions to drugs].

Area of Science:

• Pharmacology
• Dermatology
• Immunology

Background:

• Adverse drug reactions (ADRs) are a significant global health concern, contributing to morbidity and mortality.
• ADRs are classified into Type A (dose-dependent, predictable) and Type B (idiosyncratic, unpredictable) reactions.
• Cutaneous ADRs range from common maculopapular exanthema to rare, life-threatening severe cutaneous reactions.

Purpose of the Study:

• To review the spectrum of cutaneous adverse drug reactions.
• To discuss the unique challenges posed by immune-related adverse events (irAEs) in patients undergoing immunotherapy.
• To highlight the clinical significance of skin changes as potential indicators of therapeutic response.

Main Methods:

• Literature review of ADRs and cutaneous manifestations.
• Analysis of classification and clinical presentation of ADRs.
• Discussion of immunotherapies and associated immune-related adverse events (irAEs).

Main Results:

• Type A ADRs are common and predictable, while Type B ADRs are rare and unpredictable, often requiring individual patient assessment.
• Maculopapular exanthema is the most frequent cutaneous ADR, typically a Type IV hypersensitivity reaction.
• Skin changes associated with immune checkpoint inhibitors and immunotherapies (irAEs) are frequent and may correlate with treatment efficacy.

Conclusions:

• Understanding the diverse clinical presentations of cutaneous ADRs is crucial for patient management.
• Serious cutaneous ADRs, though rare, necessitate prompt recognition and intervention.
• Immune-related adverse events (irAEs) are an expected consequence of immunotherapy and can serve as biomarkers for treatment response.