Abstract
Hypersensitivity syndromes are a group of immune reactions that are produced after exposure to an inciting stimulus. The spectrum of disease ranges from an acute, isolated cutaneous eruption like a fixed drug reaction to fulminant, life-threatening reactions such as Stevens-Johnson syndrome. Most common triggers include medications, infections, or autoimmunity. Many of the syndromes are self-limited, and treatment is targeted toward symptoms relief and/or supportive care.
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References
Sackesen C, Sekerel BE, Orhan F, Kocabas CN, Tuncer A, Adalioglu G. The etiology of different forms of urticaria in childhood. Pediatr Dermatol. 2004;21(2):102.
Kane K, Lio P, Stratigos A, Johnson R, editors. Color atlas and synopsis of pediatric dermatology. 2nd ed. New York: McGraw-Hill Professional Publishing; 2009.
Hampel F, Ratner P, Haeusler JM. Safety and tolerability of levocetirizine dihydrochloride in infants and children with allergic rhinitis or chronic urticaria. Allergy Asthma Proc. 2010;31(4):290–5.
Wan KS, Chang YS. Efficacy of leukotriene receptor antagonist with anti-H1 receptor antagonist plus anti-H2 receptor antagonist for treatment of refractory chronic idiopathic urticaria. J Dermatol Treat. 2014;25(6):459–61.
Greenberger PA. Chronic urticarial: new management options. World Allergy Organ J. 2014;7(1):31.
Saini SS, Bindslev-Jensen C, Maurer M, Grob JJ, Bülbül Baskan E, Bradley MS, et al. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized. Placebo-Controlled Study. J Invest Dermatol. 2014. doi:10.1038/jid.2014.512.
Neverman L, Weinberger M. Treatment of chronic urticaria in children with antihistamines and cyclosporine. J Allergy Clin Immunol Pract. 2014;2(4):434–8.
Duffey H, Firszt R. Management of acute attacks of hereditary angioedema: role of ecallantide. J Blood Med. 2015;6:115–23.
Bigby M. Rates of cutaneous reactions to drugs. Arch Dermatol. 2001;137(6):765–70.
Ioseliani M, Lekishvili M. Pediatric drug induced hypersensitivity syndrome: case report. Georgian Med News. 2011;193:90–2.
Cernadas JR, Brockow K, Romano A, Aberer W, Torres MJ, Bircher A, et al. General considerations on rapid desensitization for drug hypersensitivity – a consensus statement. Allergy. 2010;65(11):1357.
Lee B, Yu HJ, Kang ES, Lee M, Lee J. Human leukocyte antigen genotypes and trial of desensitization in patients with oxcarbazepine-induced skin rash: a pilot study. Pediatr Neurol. 2014;51(2):207–14.
Korkij W, Soltani K. Fixed drug eruption. A brief review. Arch Dermatol. 1984;120(4):520.
Mizukawa Y, Shiohara T. Trauma-localized fixed drug eruption: involvement of burn scars, insect bites and venipuncture sites. Dermatology. 2002;205(2):159.
Khaled A, Kharfi M, Ben Hamida M, El Fekih N, El Aidli S, Zeglaoui F, et al. Cutaneous adverse drug reactions in children. A series of 90 cases. Tunis Med. 2012;90(1):45–50.
Shiohara T, Mizukawa Y. Fixed drug eruption: a disease mediated by self-inflicted responses of intraepidermal T cells. Eur J Dermatol. 2007;17(3):201.
Mizukawa Y, Yamazaki Y, Teraki Y, Hayakawa J, Hayakawa K, Nuriya H, et al. Direct evidence for interferon-gamma production by effector-memory-type intraepidermal T cells residing at an effector site of immunopathology in fixed drug eruption. Am J Pathol. 2002;161(4):1337.
Mahboob A, Haroon TS. Drugs causing fixed eruptions: a study of 450 cases. Int J Dermatol. 1998;37(11):833–8.
Mahboob A, Haroon TS, Iqbal Z, Iqbal F, Saleemi MA, Munir A. Fixed drug eruption: topical provocation and subsequent phenomena. J Coll Phys Surg Pak. 2006;16(12):747–50.
Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. N Engl J Med. 1994;331(19):1272.
Nirken M, High W, Jean-Claude R. Stevens-Johnson syndrome and toxic epidermal necrolysis: Pathogenesis, clinical manifestations, and diagnosis. UpToDate. 2014. Available at: http://tinyurl.com/jwdrhce. Accessed 15 Dec 2014.
Levi N, Bastuji-Garin S, Mockenhaupt M, Roujeau JC, Flahault A, Kelly JP, et al. Medications as risk factors of Stevens-Johnson syndrome and toxic epidermal necrolysis in children: a pooled analysis. Pediatrics. 2009;123(2):e297–304.
Wetter DA, Camilleri MJ. Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic. Mayo Clin Proc. 2010;85(2):131–8.
Ball R, Ball LK, Wise RP, Braun MM, Beeler JA, Salive ME. Stevens-Johnson syndrome and toxic epidermal necrolysis after vaccination: reports to the vaccine adverse event reporting system. GrePediatr Infect Dis J. 2001;20(2):219.
Finkelstein Y, Soon GS, Acuna P, George M, Pope E, Ito S, et al. Recurrence and outcomes of Stevens-Johnson syndrome and toxic epidermal necrolysis in children. Pediatrics. 2011;128(4):723–8.
Westly ED, Wechsler HL. Toxic epidermal necrolysis. Granulocytic leukopenia as a prognostic indicator. Arch Dermatol. 1984;120(6):721.
Rzany B, Hering O, Mockenhaupt M, Schröder W, Goerttler E, Ring J, et al. Histopathological and epidemiological characteristics of patients with erythema exudativum multiforme major, Stevens-Johnson syndrome and toxic epidermal necrolysis. Br J Dermatol. 1996;135(1):6.
Garcia-Doval I, LeCleach L, Bocquet H, Otero XL, Roujeau JC. Toxic epidermal necrolysis and Stevens-Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death? Arch Dermatol. 2000;136(3):323.
Palmieri TL, Greenhalgh DG, Saffle JR, Spence RJ, Peck MD, Jeng JC, et al. A multicenter review of toxic epidermal necrolysis treated in U.S. burn centers at the end of the twentieth century. J Burn Care Rehabil. 2002;23(2):87.
Barron SJ, Del Vecchio MT, Aronoff SC. Intravenous immunoglobulin in the treatment of Stevens–Johnson syndrome and toxic epidermal necrolysis: a meta-analysis with meta-regression of observational studies. Intl J Derm. 2014;54:108–15.
Wang YM, Tao YH, Feng T, Li H. Beneficial therapeutic effects of hemoperfusion in the treatment of severe Stevens-Johnson syndrome/toxic epidermal necrolysis: preliminary results. Eur Rev Med Pharmacol Sci. 2014;18(23):3696–701.
Patel T, Yosipovitch G. Therapy of pruritus. Expert Opin Pharmacother. 2010;11(10):1673–82.
Michaud AP, Bauman NM, Burke DK, Manaligod JM, Smith RJ. Spastic diplegia and other motor disturbances in infants receiving interferon-alpha. Larynoscope. 2004;114(7):1231–6.
Ubogy Z, Persellin RH. Suppression of erythema nodosum by indomethacin. Acta Derm Venereol. 1982;62(3):265.
Marshall JK, Irvine EJ. Successful therapy of refractory erythema nodosum associated with Crohn’s disease using potassium iodide. Can J Gastroenterol. 1997;11(6):501.
Jauhola O, Ronkainen J, Autio-Harmainen H, Koskimies O, Ala-Houhala M, Arikoski P. Cyclosporine A vs. methylprednisolone for Henoch-Schönlein nephritis: a randomized trial. Pediatr Nephrol. 2011;26(12):2159–66.
Tamburro JE, Esterly NB. Hypersensitivity syndromes. Adolesc Med. 2001;12(2):323.
Kanai H, Sawanobori E, Kobayashi A, Matsushita K, Sugita K, Higashida K. Early treatment with methylprednisolone pulse therapy combined with tonsillectomy for heavy proteinuric henoch-schönlein purpura nephritis in children. Nephron Extra. 2011;1(1):101–11.
Shin JI, Park JM, Shin YH, Kim JH, Lee JS, Kim PK, et al. Can azathioprine and steroids alter the progression of severe Henoch-Schönlein nephritis in children? Pediatr Nephrol. 2005;20(8):1087–92. Epub 2005 May 12.
Singh S, Devidayal, Kumar L, Joshi K, Minz RW, Datta U. Severe Henoch-Schönlein nephritis: resolution with azathioprine and steroids. Rheumatol Int. 2002;22(4):133–7. Epub 2002 Jul 5.
Fagbemi AA, Torrente F, Hilson AJ, Thomson MA, Heuschkel RB, Murch SH. Massive gastrointestinal haemorrhage in isolated intestinal Henoch-Schonlein purpura with response to intravenous immunoglobulin infusion. Eur J Pediatr. 2007;166(9):915–9. Epub 2006 Nov 21.
Lee J, Clayton F, Shihab F, Goldfarb-Rumyantzev A. Successful treatment of recurrent Henoch-Schönlein purpura in a renal allograft with plasmapheresis. Am J Transplant. 2008;8(1):228–31.
Du Y, Hou L, Zhao C, Han M, Wu Y. Treatment of children with Henoch-Schönlein purpura nephritis with mycophenolate mofetil. Pediatr Nephrol. 2012;27(5):765–71.
Iqbal H, Evans A. Dapsone therapy for Henoch-Schönlein purpura: a case series. Arch Dis Child. 2005;90(9):985–6.
Başaran O, Cakar N, Uncu N, Celikel BA, Kara A, Cayci FS, et al. Plasma exchange therapy for severe gastrointestinal involvement of Henoch Schönlein purpura in children. Clin Exp Rheumatol. 2015;33(2 Suppl 89):S-176–80.
Cohen BA. Pediatric dermatology. 4th ed. Baltimore: Elsevier Limited; 2013.
Uziel Y, Silverman ED. Intravenous immunoglobulin therapy in a child with cutaneous polyarteritis nodosa. Clin Exp Rheumatol. 1998;16(2):187–9.
Mori M, Imagawa T, Yoshida Y, Kurozumi H, Ampo K, Mitsuda T, et al. A child of microscopic polyarteritis nodosa effectively treated with intravenous methylprednisolone pulses and serial cyclophosphamide pulse therapy. Ryumachi. 1999;39(4):664–9.
Boehm I, Bauer R. Low-dose methotrexate controls a severe form of polyarteritis nodosa. Arch Dermatol. 2000;136(2):167–9.
Mahr A, Chaigne-Delalande S, De Menthon M. Therapeutic plasma exchange in systemic vasculitis: an update on indications and results. Curr Opin Rheumatol. 2012;24(3):261–6.
Kluger N, Guillot B, Bessis D. Ulcerative cutaneous polyarteritis nodosa treated with mycophenolate mofetil and pentoxifylline. J Dermatol Treat. 2011;22(3):175–7.
Kunnamo I, Kallio P, Pelkonen P, Viander M. Serum-sickness-like disease is a common cause of acute arthritis in children. Acta Paediatr Scand. 1986;75(6):964.
Joubert GI, Hadad K, Matsui D, Gloor J, Rieder MJ. Selection of treatment of cefaclor-associated urticarial, serum sickness-like reactions and erythema multiforme by emergency pediatricians: lack of a uniform standard of care. Can J Clin Pharmacol. 1999;6(4):197.
Tatum AJ, Ditto AM, Patterson R. Severe serum sickness-like reaction to oral penicillin drugs: three case reports. Ann Allergy Asthma Immunol. 2001;86(3):330.
Kuykendall TD, Smoller BR. Lack of specificity in skin biopsy specimens to assess for acute graft-versus-host disease in initial 3 weeks after bone-marrow transplantation. J Am Acad Dermatol. 2003;49(6):1081.
Weedon D. The lichenoid reaction pattern (interface dermatitis). In: Weedon’s skin pathology. 3rd ed. Edinburgh: Elsevier Limited; 2010.
Shulman HM, Kleiner D, Lee SJ, Morton T, Pavletic SZ, Farmer E, et al. Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: II. Pathology Working Group Report. Biol Blood Marrow Transplant. 2006;12(1):31.
Furlong T, Leisenring W, Storb R, Anasetti C, Appelbaum FR, Carpenter PA. Psoralen and ultraviolet A irradiation (PUVA) as therapy for steroid-resistant cutaneous acute graft-versus-host disease. Biol Blood Marrow Transplant. 2002;8(4):206.
Couriel D, Carpenter PA, Cutler C, Bolaños-Meade J, Treister NS, Gea-Banacloche J, et al. Ancillary therapy and supportive care of chronic graft-versus-host disease: national institutes of health consensus development project on criteria for clinical trials in chronic Graft-versus-host disease: V. Ancillary Therapy and Supportive Care Working Group Report. Biol Blood Marrow Transplant. 2006;12(4):375.
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Vatanchi, M., Hebert, A.A. (2017). Hypersensitivity Syndromes. In: Teng, J., Marqueling, A., Benjamin, L. (eds) Therapy in Pediatric Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-43630-2_20
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DOI: https://doi.org/10.1007/978-3-319-43630-2_20
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