Drugs likely to cause hypersensitivity skin reactions

Mohannad Abu-Hilal, MD, is an associate professor of Medicine and head and of the Dermatology Division at McMaster University.

Which groups of drugs are most often responsible for causing severe hypersensitivity skin reactions?

Hypersensitivity reactions is a term that we use for different types of drug reactions. They could range from being mild to very severe. I think if we're meaning the severe ones—like the drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and the Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)—then the most common groups are the anticonvulsants. Those are used for the epilepsy and seizures, including phenytoin, carbamazepine, and lamotrigine.

Antimicrobials and antibiotics are also a very big group, especially sulfa medications and even antiretroviral medications—those medications used to treat HIV are also one of the major groups for causing severe reactions.