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Until recently, strict drug avoidance was the only management strategy for severe DHRs. However, the development of novel therapeutic options, including biologics and drug desensitization protocols, has shown promising results, particularly when no alternatives exist. In parallel, the search for reliable biomarkers for diagnosis and monitoring immunomodulatory strategies is essential to improve patient care. Advances in the algorithms and digital tools also offer opportunities for enhanced risk stratification and more efficient delabeling of patients who may be incorrectly classified as allergic. 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