Severe cutaneous adverse drug reaction in intensive care

Abstract

Severe cutaneous adverse drug reaction (epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP)) are complex situations, both in their diagnostic and therapeutic approach, justifying multidisciplinary management in a specialized center. In addition to mucocutaneous involvement, visceral complications can occur, which can be life-threatening in the short term. The initial management, essentially symptomatic, is intended to prevent possible long-term sequelae. Physicians should be aware of the potential role of high-risk drugs in triggering severe cutaneous adverse drug reaction, especially when predisposing factors are present. All severe cutaneous adverse drug reaction should be reported to pharmacovigilance. At a distance, allergological tests can help to confirm the culprit drug and to decide on possible alternatives.