{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T10:04:05Z","timestamp":1789898645096,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,4,17]],"date-time":"2014-04-17T00:00:00Z","timestamp":1397692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Drug\u2010induced hypersensitivity syndrome\/drug rash with eosinophilia and systemic symptoms (<jats:styled-content style=\"fixed-case\">DIHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content>) and Stevens\u2013Johnson syndrome (<jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>)\/toxic epidermal necrolysis (<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>) represent contrasting poles of severe drug eruptions, and sequential reactivations of several herpesviruses have exclusively been demonstrated in the former. No previous studies, however, were extended beyond the acute stage. We sought to investigate whether herpesvirus reactivations could also be observed in <jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content> and beyond the acute stage of both diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a016), <jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content> overlap (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), <jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a010), and <jats:styled-content style=\"fixed-case\">DIHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a034) were enrolled. We performed a retrospective analysis of Epstein\u2013Barr virus (<jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content>), human herpesvirus 6 (<jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106), and cytomegalovirus (<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> loads sequentially determined by real\u2010time polymerase chain reaction during a 2\u2010year period after onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Persistently increased <jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content> loads were detected in <jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content> during the acute stage and long after resolution, but not in others. In contrast, high <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 loads were exclusively detected in <jats:styled-content style=\"fixed-case\">DIHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> during the acute stage. The dynamics of herpesvirus reactivation varied in <jats:styled-content style=\"fixed-case\">DIHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content> according to the use of systemic corticosteroids: While <jats:styled-content style=\"fixed-case\">EBV<\/jats:styled-content> loads were higher in patients not receiving systemic corticosteroids, <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 loads were higher in those receiving them.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Distinct patterns of herpesvirus reactivation according to the pathological phenotype and to the use of systemic corticosteroids were observed during the acute stage and follow\u2010up period, which may contribute, at least in part, to the difference in the clinical manifestations and long\u2010term outcomes. Systemic corticosteroids during the acute stage may improve the outcomes in <jats:styled-content style=\"fixed-case\">DIHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">DRESS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12410","type":"journal-article","created":{"date-parts":[[2014,4,17]],"date-time":"2014-04-17T12:02:38Z","timestamp":1397736158000},"page":"798-805","source":"Crossref","is-referenced-by-count":100,"title":["The dynamics of herpesvirus reactivations during and after severe drug eruptions: their relation to the clinical phenotype and therapeutic outcome"],"prefix":"10.1111","volume":"69","author":[{"given":"T.","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine Mitaka Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Kano","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine Mitaka Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Mizukawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine Mitaka Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Shiohara","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine Mitaka Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411103311906"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.04.048"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(96)90732-X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.07.044"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2401"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200225130-00006"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.182.6.1703"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-05-222596"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-07-2702"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.134.9.1108"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-007-8010-9"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2006.00142.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2008.02585.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2009.02.029"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2009.195"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2008.521"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.145.1.67"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1993.01680220104023"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.07807.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1995.01690230046008"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1684\/ejd.2011.1584","article-title":"Diffuse large B\u2010cell lymphoma as a sequela of Stevens\u2013Johnson syndrome associated with an increased Epstein\u2013Barr virus load","volume":"22","author":"Hirahara K","year":"2012","journal-title":"Eur J Dermatol"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01295.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-0124(12)70273-2"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1586\/eci.11.66"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-1596-8-134"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2010.03820.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-1702(01)00436-1"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1206556"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.10.017"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fall.12410","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.12410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/all.12410","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.12410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:33:59Z","timestamp":1695573239000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.12410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,17]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2014,6]]}},"alternative-id":["10.1111\/all.12410"],"URL":"https:\/\/doi.org\/10.1111\/all.12410","archive":["Portico"],"relation":{},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,17]]}}}