Delayed Cutaneous Adverse Drug Reactions

A case of maculopapular exanthema induced by amoxicillin with lesions on the trunk and hands is shown in Fig. 2.7 together with a clinical description in Sect. 2.2.4.3. Lymphocytes (CLA-n, CD3-H, DR+, CD25+) expressing adhesion molecules are attracted from the blood by adhesion molecules expressed by endothelial cells and keratinocytes and by chemokines such as CCL27 (also called cutaneous T cell-attracting chemo-kine CTACK). 

S Drug Reaction (Rash) with Eosinophilia and Systemic Symptoms 

7 Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome 

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Summarized descriptions of the most important immune-mediated delayed cutaneous adverse drug reactions follow. Readers should refer to Sect. 3.6.3 for details of the mechanisms involved in these reactions. 

Studies on chemokines such as CCL27 associated with skin-homing of T cells, and cutaneous lymphocyte-associated antigen CLA, are promising markers for aiding efforts to understand the relationship between T cells, drugs, and adverse delayed skin reactions. 

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