Cutaneous drug hypersensitivity responses (CDHRs) are a complex topic with several clinical symptoms and differential diagnoses that necessitate differentiated diagnostic tests and improved therapeutic therapy. A simple method can classify disseminated CDHRs to traditional medicines, whereas chemotherapeutics or biopharmaceuticals may exhibit drug-specific and atypical clinical manifestations. Although skin tests are the most effective method of diagnosing drug sensitization, procedures have not been sufficiently standardised. In selected patients, the need for skin tests prior to undertaking drug provocation tests (DPTs) and the use of prolonged DPTs is explored. If a suspicion exists, -lactam allergy should be ruled out. An allergist performs the conventional allergy diagnostic. Faster delabeling procedures have been devised in cases of urgent necessity due to an infection and low risk based on history. Although there is some indication that patients with mastocytosis may have a slightly greater chance of developing immediate-type drug hypersensitivity, medications do not need to be withheld for this patient group provided certain precautions are taken.

Improved diagnostic metrics are especially needed in patients with medication-induced severe cutaneous adverse responses (SCARs), both for identifying the offending drug and identifying persons at risk. Additional issues include determining suitable treatments for SCARs during both the acute and chronic phases. Recent research has improved our understanding of clinical symptoms, present disputes, and future needs in this field.

Reference: https://journals.lww.com/co-allergy/Abstract/2019/08000/Cutaneous_drug_hypersensitivity__developments_and.8.aspx