JLE

European Journal of Dermatology

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HLA and susceptibility to two distinct types of drug-induced cutaneous reactions Volume 7, issue 5, July - August 1997

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Authors
Immunology and Immunogenetic Laboratory, EP CNRS118, Medical University CHRU Dupuytren, Limoges, France.

The purpose of this work was to investigate HLA predisposition in two types of cutaneous drug reactions, which involve type IV hypersensitivity: maculo-papular papular rash, a common clinical form, and acute generalized exanthematous pustulosis, a rare form. The frequency of the DRB1*1301 DQB1*0603 haplotype was increased in the maculopapular rash (17.5% versus 6.4% in the control, relative risk (RR) = 3.7), whereas the HLA-B51(5) phenotype was increased in acute generalized exanthematous pustulosis (46.7% versus 14.6%, RR = 5.1); but the differences were not significant after correction for the p value. The culprit drugs were stratified in three categories: pristinamycin, other antibiotics and non-antibiotics: no HLA association could be established with the culprit drugs. DRB1*01 allele frequency was decreased in both types of cutaneous drug reactions, suggesting that this allele could confer a protective effect to the both types. Although these results suggest a HLA predisposition to cutaneous drug reaction, they need to be validated on a larger sample of patients.