{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T03:39:20Z","timestamp":1787974760105,"version":"build-2784847793"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"FIMARAD AAP-EpiNE"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Epidermal necrolysis (EN) is a rare and severe condition characterized by diffuse skin and mucosal detachment and mainly induced by drugs. The literature is scarce regarding the rate of recurrences and culprit drug re-exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the rate of EN recurrences and to examine re-exposure to high-notoriety drugs in patients with EN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used the French health system database and included all patients with EN. Suspected drugs were assessed at the onset of EN. The primary outcome was the rate of EN recurrence. Secondary outcomes were re-exposure or cross-exposure to high-notoriety drugs (exposure to a drug of the same family) after the acute stage of EN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 1203 of 1440 patients (83.5%) survived the acute stage, with 27 patients (2.2%, 95% confidence interval 1.5\u20133.2) meeting the recurrence criteria. In patients with allopurinol as the suspected drug, 10 of 77 (13%) were cross-exposed to febuxostat, without recurrence. Similarly, in patients with carbamazepine or oxcarbazepine as the suspected drug, 2 of 26 (8%) were cross-exposed to lamotrigine, without recurrence. Conversely, 12 of 38 (32%) and 16 of 37 (43%) patients were respectively re-exposed to pantoprazole and esomeprazole when initially suspected, and 12 of 42 (29%) were re-exposed to amoxicillin. Only one recurrence was noted in a patient re-exposed to pantoprazole.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among patients with EN, the rate of recurrence seems low, contrasting with several re-exposures to beta-lactam antibiotics and proton pump inhibitors when initially suspected. Although we cannot exclude that the suspected drugs were not the responsible ones for several patients, future studies should assess the possible existence of transient risk factors inducing EN.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llae553","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T16:47:24Z","timestamp":1736182044000},"page":"1116-1124","source":"Crossref","is-referenced-by-count":1,"title":["Recurrences and rechallenges of suspected drugs in patients with epidermal necrolysis"],"prefix":"10.1093","volume":"50","author":[{"given":"Thomas","family":"Bettuzzi","sequence":"first","affiliation":[{"name":"Service de Dermatologie, H\u00f4pital Henri Mondor, AP-HP , Cr\u00e9teil ,","place":["France"]},{"name":"EpiDermE, Universit\u00e9 Paris Est Cr\u00e9teil Val de Marne , Cr\u00e9teil ,","place":["France"]},{"name":"Centre de R\u00e9f\u00e9rence des Dermatoses Bulleuses Toxiques , ToxiBUL, Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6676-5063","authenticated-orcid":false,"given":"B\u00e9n\u00e9dicte","family":"Lebrun-Vignes","sequence":"additional","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris Est Cr\u00e9teil Val de Marne , Cr\u00e9teil ,","place":["France"]},{"name":"Service de Pharmacologie M\u00e9dicale, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, Groupe Hospitalier, AP-HP, Sorbonne Universit\u00e9 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haudrey","family":"Assier","sequence":"additional","affiliation":[{"name":"Service de Dermatologie, H\u00f4pital Henri Mondor, AP-HP , Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pina Vegas","sequence":"additional","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris Est Cr\u00e9teil Val de Marne , Cr\u00e9teil ,","place":["France"]},{"name":"Service de Rhumatologie, H\u00f4pital Henri Mondor, AP-HP , Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5383-7096","authenticated-orcid":false,"given":"Saskia","family":"Ingen-Housz-Oro","sequence":"additional","affiliation":[{"name":"Service de Dermatologie, H\u00f4pital Henri Mondor, AP-HP , Cr\u00e9teil ,","place":["France"]},{"name":"EpiDermE, Universit\u00e9 Paris Est Cr\u00e9teil Val de Marne , Cr\u00e9teil ,","place":["France"]},{"name":"Centre de R\u00e9f\u00e9rence des Dermatoses Bulleuses Toxiques , ToxiBUL, Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-5270","authenticated-orcid":false,"given":"Emilie","family":"Sbidian","sequence":"additional","affiliation":[{"name":"Service de Dermatologie, H\u00f4pital Henri Mondor, AP-HP , Cr\u00e9teil ,","place":["France"]},{"name":"EpiDermE, Universit\u00e9 Paris Est Cr\u00e9teil Val de Marne , Cr\u00e9teil ,","place":["France"]},{"name":"INSERM, Centre d\u2019Investigation Clinique 1430, H\u00f4pital Henri Mondor , Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"2025052303171810500_llae553-B1","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1016\/S0140-6736(16)30378-6","article-title":"Severe cutaneous adverse reactions to drugs","volume":"390","author":"Duong","year":"2017","journal-title":"Lancet"},{"key":"2025052303171810500_llae553-B2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/sj.jid.5701033","article-title":"Stevens\u2013Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-Study","volume":"128","author":"Mockenhaupt","year":"2008","journal-title":"J Invest Dermatol"},{"key":"2025052303171810500_llae553-B3","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1016\/j.jaad.2020.10.091","article-title":"Changing spectrum of suspected drugs of epidermal necrolysis: a World Health Organization pharmacovigilance database analysis from 1997\u20132020","volume":"85","author":"Bettuzzi","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"2025052303171810500_llae553-B4","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1001\/archderm.136.3.323","article-title":"Toxic epidermal necrolysis and Stevens\u2013Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death?","volume":"136","author":"Garcia-Doval","year":"2000","journal-title":"Arch Dermatol"},{"key":"2025052303171810500_llae553-B5","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jbspin.2015.07.011","article-title":"Risk of cutaneous adverse events with febuxostat treatment in patients with skin reaction to allopurinol. A retrospective, hospital-based study of 101 patients with consecutive allopurinol and febuxostat treatment","volume":"83","author":"Bardin","year":"2016","journal-title":"Joint Bone Spine"},{"key":"2025052303171810500_llae553-B6","doi-asserted-by":"crossref","first-page":"e124","DOI":"10.1136\/annrheumdis-2020-218226","article-title":"Cutaneous adverse events with febuxostat after previous reactions to allopurinol: comment on the article by Singh and Cleveland","volume":"81","author":"Quilis","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2025052303171810500_llae553-B7","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1016\/j.amjmed.2016.08.042","article-title":"Cross-reactions between allopurinol and febuxostat","volume":"130","author":"Lien","year":"2017","journal-title":"Am J Med"},{"key":"2025052303171810500_llae553-B8","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.eplepsyres.2008.04.003","article-title":"Cross-reactivity pattern of rash from current aromatic antiepileptic drugs","volume":"80","author":"Alvestad","year":"2008","journal-title":"Epilepsy Res"},{"key":"2025052303171810500_llae553-B9","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1177\/0091270009344985","article-title":"Hypersensitivity syndrome induced by anticonvulsants: possible cross-reactivity between carbamazepine and lamotrigine","volume":"49","author":"Aouam","year":"2009","journal-title":"J Clin Pharmacol"},{"key":"2025052303171810500_llae553-B10","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.seizure.2019.07.015","article-title":"Rashes and other hypersensitivity reactions associated with antiepileptic drugs: a review of current literature","volume":"71","author":"Mani","year":"2019","journal-title":"Seizure"},{"key":"2025052303171810500_llae553-B11","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1016\/j.jaci.2020.08.003","article-title":"Whole genome sequencing identifies genetic variants associated with co-trimoxazole hypersensitivity in Asians","volume":"147","author":"Wang","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"2025052303171810500_llae553-B12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3390\/pharmacy7030103","article-title":"Cephalosporins: a focus on side chains and \u03b2-lactam cross-reactivity","volume":"7","author":"Chaudhry","year":"2019","journal-title":"Pharmacy"},{"key":"2025052303171810500_llae553-B13","first-page":"157","article-title":"Study of cross-reactivity between proton pump inhibitors","volume":"20","author":"Sobrevia Elfau","year":"2010","journal-title":"J Investig Allergol Clin Immunol"},{"key":"2025052303171810500_llae553-B14","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1001\/jama.2014.839","article-title":"Recurrence and mortality following severe cutaneous adverse reactions","volume":"311","author":"Finkelstein","year":"2014","journal-title":"JAMA"},{"issue":"Suppl. 4","key":"2025052303171810500_llae553-B15","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1016\/j.respe.2017.05.004","article-title":"Value of a national administrative database to guide public decisions: from the Syst\u00e8me National d\u2019Information Interr\u00e9gimes de l\u2019Assurance Maladie (SNIIRAM) to the Syst\u00e8me National des Donn\u00e9es de Sant\u00e9 (SNDS) in France","volume":"65","author":"Tuppin","year":"2017","journal-title":"Rev Epidemiol Sante Publique"},{"key":"2025052303171810500_llae553-B16","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.jid.2023.09.274","article-title":"Validation of an algorithm to identify epidermal necrolysis on a medico-administrative database","volume":"144","author":"Bettuzzi","year":"2024","journal-title":"J Invest Dermatol"},{"key":"2025052303171810500_llae553-B17","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/archderm.1995.01690170041005","article-title":"Erythema multiforme with mucous membrane involvement and Stevens\u2013Johnson syndrome are clinically different disorders with distinct causes","volume":"131","author":"Assier","year":"1995","journal-title":"Arch Dermatol"},{"key":"2025052303171810500_llae553-B18","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1038\/clpt.2009.252","article-title":"ALDEN, an algorithm for assessment of drug causality in Stevens\u2013Johnson syndrome and toxic epidermal necrolysis: comparison with case\u2013control analysis","volume":"88","author":"Sassolas","year":"2010","journal-title":"Clin Pharmacol Ther"},{"key":"2025052303171810500_llae553-B19","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jemermed.2011.05.035","article-title":"The use of cephalosporins in penicillin-allergic patients: a literature review","volume":"42","author":"Campagna","year":"2012","journal-title":"J Emerg Med"},{"key":"2025052303171810500_llae553-B20","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.3899\/jrheum.110092","article-title":"Safety and efficacy of febuxostat treatment in subjects with gout and severe allopurinol adverse reactions","volume":"38","author":"Chohan","year":"2011","journal-title":"J Rheumatol"},{"key":"2025052303171810500_llae553-B21","doi-asserted-by":"crossref","first-page":"e13316","DOI":"10.1111\/ijcp.13316","article-title":"Risk of cutaneous adverse reactions associated with allopurinol or febuxostat in real-world patients: a nationwide study","volume":"73","author":"Lin","year":"2019","journal-title":"Int J Clin Pract"},{"key":"2025052303171810500_llae553-B22","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1038\/srep00331","article-title":"Different inhibitory potency of febuxostat towards mammalian and bacterial xanthine oxidoreductases: insight from molecular dynamics","volume":"2","author":"Kikuchi","year":"2012","journal-title":"Sci Rep"},{"key":"2025052303171810500_llae553-B23","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1038\/428486a","article-title":"A marker for Stevens\u2013Johnson syndrome","volume":"428","author":"Chung","year":"2004","journal-title":"Nature"},{"key":"2025052303171810500_llae553-B24","doi-asserted-by":"crossref","first-page":"4134","DOI":"10.1073\/pnas.0409500102","article-title":"HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol","volume":"102","author":"Hung","year":"2005","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2025052303171810500_llae553-B25","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11882-019-0841-y","article-title":"Pediatric drug hypersensitivity","volume":"19","author":"Rukasin","year":"2019","journal-title":"Curr Allergy Asthma Rep"},{"key":"2025052303171810500_llae553-B26","doi-asserted-by":"crossref","first-page":"46ra62","DOI":"10.1126\/scitranslmed.3001116","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS): a multiorgan antiviral T cell response","volume":"2","author":"Picard","year":"2010","journal-title":"Sci Transl Med"},{"key":"2025052303171810500_llae553-B27","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1684\/ejd.2021.4103","article-title":"Immunosuppressants as steroid-sparing agents for chronic DRESS: four cases","volume":"31","author":"Ingen-Housz-Oro","year":"2021","journal-title":"Eur J Dermatol"},{"key":"2025052303171810500_llae553-B28","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1111\/jdv.18808","article-title":"Management and treatment outcome of DRESS patients in Europe: an international multicentre retrospective study of 141 cases","volume":"37","author":"Kridin","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025052303171810500_llae553-B29","doi-asserted-by":"crossref","first-page":"AB115","DOI":"10.1016\/j.jaci.2022.12.364","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) with dual sensitization to both vancomycin and ceftriaxone","volume":"151","author":"Krantz","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"2025052303171810500_llae553-B30","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.annder.2012.03.017","article-title":"[Does hypersensitivity to multiple drugs really exist?]","volume":"139","author":"Studer","year":"2012","journal-title":"Ann Dermatol Venereol"}],"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llae553\/61355128\/llae553.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/50\/6\/1116\/61355128\/llae553.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/50\/6\/1116\/61355128\/llae553.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T07:17:25Z","timestamp":1747984645000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/article\/50\/6\/1116\/7943489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,6]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,1,6]]},"published-print":{"date-parts":[[2025,5,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ced\/llae553","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,1,6]]}}}