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Comment & Response
December 18, 2019

Implementation of Genetic Screening to Prevent Severe Cutaneous Adverse Drug Reactions Is Crucial—Rebuttal From the Devil’s Antagonist

Author Affiliations
  • 1Mississauga Academy of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Sunnybrook Health Sciences Centre, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 3The Ruth and Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
  • 4Department of Dermatology, Emek Medical Centre, Afula, Israel
JAMA Dermatol. 2020;156(2):220-221. doi:10.1001/jamadermatol.2019.3950

To the Editor We were delighted to read the editorial by Divito1 and find growing attention to severe cutaneous adverse [drug] reactions (SCARs). In the last 2 decades, endeavors by international multidisciplinary scientific networks have greatly advanced our understanding of the pathogenesis of SCARs. An important innovation has been translating the discoveries in SCAR pharmacogenetics into preventive genetic screening of at-risk populations. Notable HLA antigen drug associations for SCARs include HLA-B*57:01 (abacavir-induced Stevens-Johnson syndrome/toxic epidermal necrolysis [SJS/TEN] and drug reaction eosinophilia and systemic symptoms [DRESS]), HLA-B*15:02 (carbamazepine-induced SJS/TEN), HLA-B*58:01 (allopurinol-induced SJS/TEN and DRESS), and HLA-B*13:01 (dapsone-induced DRESS). Screening programs have been established by governments across Asia, including Taiwan, Hong Kong, Singapore, and Thailand.

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