ABSTRACT
Severe cutaneous adverse reactions (SCARs) include Stevens-Johnson syndrome/toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms and acute generalized exanthematous pustulosis. These three entities are classically considered part of the SCAR spectrum; however, other entities like exfoliative dermatitis, drug-induced vasculitis, generalized fixed drug eruption, anaphylaxis, anticoagulant-induced skin necrosis, and angioedema can sometimes be severe enough to cause life-threatening illness and are considered SCAR by some authorities. Assessing the severity of the reaction, finding its nature, determining the drug responsible, and supporting investigations are key to diagnosing these severe reactions. Stopping the incriminated drug immediately, supportive therapy and specific therapy are the cornerstones of management. As we know that SCARs are life-threatening dermatoses, it is important to counsel the patient about use of drugs after recovery to prevent future episodes. At the same time, it is also important to tell the patient which drugs are safe for him or her, else patient and physicians become too fearful of drugs. Severe cutaneous adverse reactions are fortunately not common; however, on occurrence, they can result in morbidity and mortality. Systemic involvement is frequent and a multidisciplinary approach to treatment is required in most cases. It is important to identify these conditions promptly and institute life-saving treatment at the earliest.
