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However, idiosyncratic drug\u2010induced immune activated (type B) reactions contribute to a range of hypersensitivity reactions, with T\u2010cell\u2010mediated type IV hypersensitivity reactions mainly manifesting as cutaneous ADRs (cADRs). Aromatic antiepileptic drugs (AEDs), used in the treatment of epilepsy as well as bipolar disorder or neuropathic pain, have been implicated as culprit drugs in a spectrum of pathologies ranging from mild maculopapular exanthema (MPE) to severe and life\u2010threatening conditions including drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens\u2010Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These AED\u2010induced cADRs are unpredictable based on pharmacological and clinical factors alone, thereby prompting investigations into genomic contributors mediating risk of pathology. The most strongly associated risk genes identified are from the human leukocyte antigen (HLA) class I alleles, which play a critical role in adaptive immunity by flagging either infected or aberrant cells for recognition by surveying T\u2010cells. In the setting of drug hypersensitivity, the immunogenicity of HLA molecules and their peptide cargo can be modulated by interactions with small drug molecules that drive inappropriate T\u2010cell responses. 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