{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:48:01Z","timestamp":1782172081690,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T00:00:00Z","timestamp":1625529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Severe cutaneous adverse drug reactions (SCARs) including Stevens\u2010Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP) are high\u2010mortality adverse drug reactions. The risk factors and prognosis of drug\u2010induced liver injury (DILI) concomitant with SCAR warrant clarification. We aimed to evaluate the characteristics and outcomes of DILI with SCAR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed the database of a 10\u2010year multi\u2010centre prospective study in Taiwan from 2011 to 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1415 patients with DILI were enrolled, including 81 cases combined with SJS\/TEN, 74 with DRESS, 3 with AGEP and 1257 with pure DILI. Approximated 11.2% of patients had SCAR, of which allopurinol was the leading incriminated drug, followed by sulphonamides and carbamazepine. The SJS\/TEN group had the highest mortality (34.6%). Jaundice, acute kidney injury and SJS\/TEN were independent risk factors of mortality (odds ratio: 29.54, 4.43 and 4.86, respectively, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.003). Chronic kidney disease with high\u2010dose allopurinol also contributed to high mortality (78.9%) in cases of allopurinol\u2010induced DILI with SCAR. The <jats:italic>HLA\u2010B*5801<\/jats:italic> was associated with a high risk and mortality of allopurinol\u2010induced DILI with SCAR. Likewise, the <jats:italic>HLA\u2010B*1502<\/jats:italic> was closely related to carbamazepine\u2010induced DILI with SCAR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DILI patients combined with SCAR are common and have a high mortality in Taiwan. Allopurinol is the leading incriminated drug. Jaundice, acute kidney injury and SJS\/TEN are risk factors of mortality. <jats:italic>HLA\u2010B*5801,<\/jats:italic> chronic kidney disease and high drug dosage also contribute to high mortality in allopurinol\u2010induced DILI with SCAR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14990","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T16:22:41Z","timestamp":1624292561000},"page":"2671-2680","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Drug\u2010induced liver injury associated with severe cutaneous adverse drug reactions: A nationwide study in Taiwan"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7942-2078","authenticated-orcid":false,"given":"Yi\u2010Shin","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Taipei Veterans General Hospital, &amp; National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen\u2010Yi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Taipei Veterans General Hospital, &amp; National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting\u2010Tsung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9030-6086","authenticated-orcid":false,"given":"Cheng\u2010Yuan","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Center for Digestive Medicine China Medical University Hospital Taichung 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