Ethnic Differences in the Association Between Human Leukocyte Antigen and Stevens-Johnson Syndrome

The HLA-B12 antigen is significantly increased in Caucasian patients with Stevens-Johnson syndrome (SJS) with ocular complications, while HLA-A*0206 is strongly associated with Japanese patients with SJS/toxic epidermal necrolysis (TEN) with ocular complications. There are strong ethnic differences in the association between HLA and SJS/TEN. Regarding the association between HLA and drug-induced severe cutaneous adverse reactions (SCAR), including SJS and TEN, the strong allopurinol-specific association between HLA-B*5801 and allopurinol-induced SCAR may be a universal phenomenon, since it has been identified in all Han Chinese, Caucasian and Japanese patients. In contrast, the carbamazepine-specific association between HLA-B*1502 and carbamazepine-induced SJS may be specific to certain ethnic groups, as it has been identified in Han Chinese but not in Caucasian and Japanese patients. Dermatologists have reported that allopurinol and anticonvulsant drugs such as carbamazepine are commonly associated with SJS/TEN, while many of the author’s patients developed SJS after receiving treatment for the common cold with antibiotics, cold remedies and/or non-steroidal antiinflammatory drugs (NSAIDs). This article posits that the SJS/TEN patients seen by dermatologists are not always the same as the SJS/TEN patients consulting opthalmologists.