Skip to main content
SpringerLink
Log in

Role of Epidermal Dendritic Cells in Drug-Induced Cutaneous Adverse Reactions

  • Chapter
Dendritic Cells

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 188))

Abstract

Drug-induced adverse reactions (ADR) include any undesirable pharmacological effect that occurs following drug administration at therapeutic doses. The appearance of ADR significantly limits the use of drugs in as much as their clinical symptoms may range from very mild discomfort such as cutaneous rash, up to very severe, or even fatal tissue necrolysis such as the Stevens Johnson syndrome.

One of the most frequently involved organ during ADR is the skin. Drug-induced cutaneous reactions (CDR) incidence is variable but they may appear in 2–3% of ambulatory patients, and it may increase to 10–15% when patients are hospitalized, or even be as high as 60% when co morbidity includes the presence of virus, bacteria, or parasites.

Due to the fact that skin is one of the organs most frequently involved in ADR, in this work we analyze and propose a mechanism by which epidermal dendritic cells operating as the sentinels of the skin neuro-immune-endocrine system may contribute to CDR via either immunogenic or tolerogenic immune responses towards drugs, whenever they are administered topic or systemically.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Ali A, Rautemaa R, Hietanen J, Beklen A, Konttinen Y (2007) A possible CD1a Langerhans cell-mast cell interaction in chronic hyperplastic candidosis. J Oral Pathol Med 36:329–336

    PubMed  CAS  Google Scholar 

  • Allan RS, Waithman J, Bedoui S, Jones CM, Villadangos JA, Zhan Y, Lew AM, Shortman K, Heath WR, Carbone FR (2006) Migratory dendritic cells transfer antigen to a lymph node-resident dendritic cell population for efficient CTL priming. Immunity 25:153–162

    Article  PubMed  CAS  Google Scholar 

  • Ayala-García I, Hernández-Segura AM, Castell-Rodríguez AE, Alvarez-Pérez J, Hernández-Tellez B, Ramírez-González MD (2005) Participation of epidermal Langerhans cells in human pathology and their potential as targets for drug developmet: a review of literature. Proc West Pharmacol Soc 48:13–20

    PubMed  Google Scholar 

  • Beltraminelli HS, Lerch M, Arnold A, Bircher AJ, Haeusermann P (2005) Acute generalized ex-anthematous pustulosis induced by the antifungal terbinafine: case report and review of the literature. Br J Dermatol 152:780–783

    Article  PubMed  CAS  Google Scholar 

  • Blanca M, Cornejo-Garcia JA, Torres MJ, Mayorga C (2005) Specificities of B cell reactions to drugs. The penicillin model. Toxicology 209:181–184

    Article  PubMed  CAS  Google Scholar 

  • Bronnimann M, Yawalkar, N (2005) Histopathology of drug-induced exanthems: is there a role in diagnosis of drug allergy? Curr Opin Allergy Clin Immunol 5:317–321

    Article  PubMed  Google Scholar 

  • Brunton LL, Lazo JS, Parker KL (2006). Goodman and Gilman's the pharmacological basis of therapeutics, 11th edn. McGraw Hill, New York, USA, pp. 127–128, 1406–1424, 1741–1744

    Google Scholar 

  • Burrell R, Flaherty DK, Sauers LJ (1992). Toxicology of the immune system: a human approach. VanNostrand Reinhold, New York, USA, pp. 235–292

    Google Scholar 

  • Caux C, Dezutter-Damuyant C, Schmitt D, Banchereau J (1992) GM-CSF and TNF-alpha cooperate in the generation of dendritic Langerhans cells. Nature 360:258–261

    Article  PubMed  CAS  Google Scholar 

  • Cheong C, Idoyaga J, Do Y, Pack M, Park SH, Lee H, Kang YS, Choi JH, Kim JY, Bonito A, Inaba K, Yamazaki S, Steinman RM, Park CG (2007) Production of monoclonal antibodies that recognize the extracellular domain of mouse Langerin/CD207. J Immunol Methods 324:48–62

    Article  PubMed  CAS  Google Scholar 

  • Chu DH, Haake AR, Holbrook K, Loomis CA (2003) The structure and development of skin. In: Fitzpatrick's Dermatology in general medicine, 6th edn. McGraw Hill, New York, USA, pp. 58–88

    Google Scholar 

  • Demirkan K, Bozkurt B, Karakaya G, Kalyoncu AF (2006) Anaphylactic reaction to drugs commonly used for gastrointestinal system diseases: 3 case reports and review of the literature. J Investig Allergol Clin Immunol 16:203–209

    PubMed  CAS  Google Scholar 

  • Demoly P, Hillaire-Buys D (2004) Classification and epidemiology of hypersensitivity drug reactions. Immunol Allergy Clin N Am 24:345–356

    Article  Google Scholar 

  • Descotes J, Choquet-Kastylevsky G (2001) Gell and Coombs's classification: is it still valid? Toxicology 158:43–49

    Article  PubMed  CAS  Google Scholar 

  • FDA (2004) Serious adverse event definition. In: http://www.fad.gov/medwatch/report/DESK/ ad-vent.htm. Updated on Jan 23th, 2004. Accessed on March 10th, 2008

  • Flacher V, Bouschbacher M, Verronese E, Massacrier C, Berthier-Vergnes O, DeSaint-Vis B, Caux C, Dezutter-Dambuyant C, Lebecque S, Valladau J (2006) Human Langerhans cells express a specific TLR profile and differentially respond to virus and Gram-positive bacteria. J Immunol 177:7959–7967

    PubMed  CAS  Google Scholar 

  • Geissmann F, Dieu-Nosjean MC, Dezutter C, Valladeau J, Kayal S, Leborgne M, Brousse N, Sae-land S, Davoust J (2002) Accumulation of immature Langerhans cell in human lymph nodes draining chronically inflamed skin. J Exp Med 196:417–430

    Article  PubMed  CAS  Google Scholar 

  • Ginhoux F, Tacke F, Angeli V, Bogunovic M, Loubeau M, Dai XM, Stanley ER, Randolph GJ, Merad M (2006) Langerhans cells arise from monocytes in vivo. Nat Immunol 7:265–273

    Article  PubMed  CAS  Google Scholar 

  • Hacker C, Kirsch RD, Ju XS, Hieronymus T, Gust TC, Kuhl C, Jorgas T, Kurz SM, Rose-John S, Yokota Y, Zenke M (2003) Transcriptional profiling identifies Id2 function in dendritic cell development. Nat Immunol 4:380–386

    Article  PubMed  CAS  Google Scholar 

  • Hammond-Thelin LA (2008) Cutaneous reactions related to systemic immunomodulators and targeted therapeutics. Dermatol Clin 26:121–159

    Article  PubMed  CAS  Google Scholar 

  • Hengge UR, Ruzicka T, Schwartz RA, Cork MJ (2006) Adverse effects of topical glucocorticos-teroids. J Am Acad Dermatol 54:1–15

    Article  PubMed  Google Scholar 

  • Henri S, Siret C, Machy P, Kissenpfennig A, Malissen B, Leserman L (2007) Mature DC from skin and skin-draining LN retain ability to acquire and efficiently present targeted antigen. Eur J Immunol 37:1184–1193

    Article  PubMed  CAS  Google Scholar 

  • Hertl-Yazdi MS, Hertl M (2005) Bullous drug reactions. Hautarzt 56:16–23

    Article  PubMed  CAS  Google Scholar 

  • Ioulios P, Charalampos M, Efrossini T (2003) The spectrum of cutaneous reactions associated with calcium antagonists: a review of the literature and the possible etiopathogenic mechanisms. Dermatol Online J 9:6–11

    PubMed  Google Scholar 

  • Jones DH, Todd M, Craig TJ (2004) Early diagnosis is key in vancomycin-induced linear IgA bullous dermatosis and Stevens-Johnson syndrome. J Am Osteopath Assoc 104:157–163

    PubMed  Google Scholar 

  • Kanitakis J, Petruzzo P, Dubernard JM (2004) Turnover of epidermal Langerhans cells. N Eng J Med 351:2661–2662

    Article  CAS  Google Scholar 

  • Kaplan DH, Jenison MC, Sealand S, Shlomchik WD, Shlomchick MJ (2005) Epidemal Langerhans cell-deficient mice develop enhanced contact hypersensitivity. Immunity 23:611–620

    Article  PubMed  CAS  Google Scholar 

  • Kissenpfennig A, Ait-Yahia S, Clair-Moninot V, Stossel H, Badell E, Bordat Y, Pooley JL, Lang T, Prina E, Coste I, Gresser O, Renno T, Winter N, Milon G, Shortman K, Romani N, Lebecque S, Malissen B, Sealand S, Douillard P (2005) Disruption of the langerin/CD207 gene abolishes Birbeck granules without a marked loss of Langerhans cells function. Mol Cell Biol 25:88–99

    Article  PubMed  CAS  Google Scholar 

  • Knowles SR, Shear NH (2007) Recognition and management of severe cutaneous drug reactions. Dermatol Clin 25:245–253

    Article  PubMed  CAS  Google Scholar 

  • Knowles SR, Shapiro LE, Shear NH (2003) Reactive metabolites and adverse drug reactions: clinical considerations. Clin Rev Allergy Immunol 24:229–238

    Article  PubMed  CAS  Google Scholar 

  • Kobayashi KS, Flavell RA (2004) Shielding the double-edged sword: negative regulation of the innate immune system. J Leukoc Biol 75:428–433

    Article  PubMed  CAS  Google Scholar 

  • Lebrec H, Kerdine S, Gaspard I, Pallardy M (2001) Th(1)/Th(2) responses to drugs. Toxicology 158:25–29

    Article  PubMed  CAS  Google Scholar 

  • Litt JZ (2007) Litt's drug eruption reference manual, 13th edn. Informa Healthcare Pub, London, UK

    Google Scholar 

  • Lopez S, Blanca-Lopez N, Cornejo-Garcia JA, Canto G, Torres MJ, Mayorga C, Blanca M (2007) Nonimmediate reactions to betalactams. Curr Opin Allergy Clin Immunol 7:310–316

    Article  PubMed  Google Scholar 

  • Loser K, Mehling A, Loeser S, Apelt J, Kuhn A, Grabbe S, Schwarz T, Penninger JM, Beissert S (2006) Epidermal RANKL controls regulatory T-cell numbers via activation of dendritic cells. Nat Med 12:1372–1379

    Article  PubMed  CAS  Google Scholar 

  • Lotze MT, Thomson AW (2001) Dendritic cells, 2th edn. Academic Press, San Diego, USA

    Google Scholar 

  • Luther J, Glesby MJ (2007) Dermatologic adverse effects of antiretroviral therapy: recognition and management. Am J Clin Dermatol 8:221–233

    Article  PubMed  Google Scholar 

  • Maestroni GJ (2004) Modulation of skin norepinephrine turnover by allergen sensitization: impact on contact hypersensitivity and T helper priming. J Invest Dermatol 122:119–124

    Article  PubMed  CAS  Google Scholar 

  • Maldonado-López R, De Smedt T, Michel P, Godfroid J, Pajak B, Heirman C, Thielemans K, Leo O, Urbain J, Moser M (1999) CD8α+ and CD8α− subclasses of dendritic cells direct the development of distinct T helper cells in vivo. J Exp Med 189:587–592

    Article  PubMed  Google Scholar 

  • Martin SF (2004) T lymphocyte-mediated immune responses to chemical haptens and metal ions: implications for allergic and autoimmune disease. Int Arch Allergy Immunol 134:186–198

    Article  PubMed  CAS  Google Scholar 

  • Mertes PM, Laxenaire MC (2004) Adverse reactions to neuromuscular blocking agents. Curr Allergy Asthma Rep 4:7–16

    Article  PubMed  Google Scholar 

  • Mockenhaupt M (2005) Severe cutaneous adverse drug reactions. Clinical features and epidemiology. Hautarzt 56:24–31

    Article  PubMed  CAS  Google Scholar 

  • Mohamadzadeh M, Chen L, Schmaljohn AL (2007) How Ebola and Marburg viruses battle the immune system. Nat Rev Immunol 7:556–567

    Article  PubMed  CAS  Google Scholar 

  • Naisbitt DJ, Pirmohamed M, Park BK (2007) Immunological principles of T-cell-mediated adverse drug reactions in skin. Expert Opin Drug Saf 6:109–124

    Article  PubMed  CAS  Google Scholar 

  • Nikkels AF, Nikkels-Tassoudji N, Pierard GE (2006) Oral antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis: case reports and review of the literature. Am J Clin Der-matol 7:327–331

    Article  Google Scholar 

  • Nishioka K, Groreishi M, Yokozeki H (1999) Heat shock proteins and skin diseases. Curr Opin Infect Dis 12:171–176

    PubMed  CAS  Google Scholar 

  • Orion E, Matz H, Wolf R (2005) The life-threatening complications of dermatologic therapies. Clin Dermatol 23:182–192

    Article  PubMed  Google Scholar 

  • Peiser M, Koeck J, Kirschning CJ, Wittig B, Wanner R (2008) Human Langerhans cells selectively activated via Toll-like receptor 2 agonists acquire migratory and CD4+ T cell stimulatory capacity. J Leukoc Biol 83:1118–1127

    Article  PubMed  CAS  Google Scholar 

  • Picardo M, Zompetta C, Marchese C, De Luca C, Faggioni A, Schmidt RJ, Santucci B (1992) Paraphenylenediamine, a contact allergen, induces oxidative stress and ICAM-1 expression in human keratinocytes. Br J Dermatol 126:450–455

    Article  PubMed  CAS  Google Scholar 

  • Pichler WJ, Beeler A, Keller M, Lerch M, Posadas S, Schmid D, Spanou Z, Zawodniak A, Ger-ber B (2006) Pharmacological interaction of drugs with immune receptors: the p-I concept. Allergology Int 55:17–25

    Article  CAS  Google Scholar 

  • Pivarcsi A, Gombert M, Dieu-Nosjean MC, Lauerma A, Kubitza R, Meller S, Rieker J, Muller A, Da Cunha L, Haahtela A, Sonkoly E, Fridman WH, Alenius H, Kemeny L, Ruzicka T, Zlotnik A, Homey B (2004) CC chemokine ligand 18, an atopic dermatitis-associated and dendritic cell-derived chemokine, is regulated by staphylococcal products and allergen exposure. J Immunol 173:5810–5817

    PubMed  CAS  Google Scholar 

  • Randolph GJ, Ochando J, Partida-Sanchez S (2008) Migration of dendritic cell subsets and their precursors. Annu Rev Immunol 26:293–316

    Article  PubMed  CAS  Google Scholar 

  • Riedl MA, Casillas AM (2003) Adverse drug reactions: types and treatment options. Am Fam Med 68:1781–1790

    Google Scholar 

  • Rodriguez-Pena R, Antunez C, Martin E, Blanca-Lopez N, Mayorga C, Torres MJ (2006) Allergic reactions to beta-lactams. Expert Opin Drug Saf 5:31–48

    Article  PubMed  CAS  Google Scholar 

  • Rodríguez Velasco JG, Torres Valdos JE, Montero Mora P, Juárez Morales DT, Rodríguez E, Almeida Arvizu VM (2006) Reactions to drugs. A review of literature. Rev Alerg Mex 53: 73–75

    PubMed  Google Scholar 

  • Romano A, Demoly P (2007) Recent advances in the diagnosis of drug allergy. Curr Opin Allergy Clin Immunol 7:299–303

    PubMed  Google Scholar 

  • Roosterman D, Goerge T, Schneider SW, Bunnett NW, Steinhoff M (2006) Neuronal Control of Skin Function: the Skin as a neuroimmunoendocrine organ. Physiol Rev 86:1309–1379

    Article  PubMed  CAS  Google Scholar 

  • Roujeau JC (2006) Immune mechanisms in drug allergy. Allergology Int 55:27–33

    Article  CAS  Google Scholar 

  • Roychowdhury S, Svensson CK (2005) Mechanisms of drug-induced delayed-type hypersensitiv-ity reactions in the skin. AAPS J 7:E834–E846

    Google Scholar 

  • Saeki M, Saito Y, Nagano M, Teshima R, Ozawa S, Sawada J (2002) mRNA expression of multiple cytochrome p450 isozymes in four types of cultured skin cells. Int Arch Allergy Immunol 127:333–336

    Article  PubMed  CAS  Google Scholar 

  • Sanborn RE, Sauer DA (2008) Cutaneous reactions to chemotherapy: commonly seen, less described, little understood. Dermatol Clin 26:103–119

    Article  PubMed  CAS  Google Scholar 

  • Schmid-Wendtner MH, Korting HC (2006) The pH of the Skin Surface and Its Impact on the Barrier Function. Skin Pharmacol Physiol 19:296–302

    Article  PubMed  Google Scholar 

  • Schoeters E, Verheyen GR, Nelissen I, Van Rompay AR, Hooyberghs J, Van Den Heuvel RL, Witters H, Schoeters GER, Van Tendeloo VFI, Berneman ZN (2007) Microarray analyses in dendritic cells reveal potential biomarkers for chemical-induced skin sensitization. Mol Immunol 44:3222–3233

    Article  PubMed  CAS  Google Scholar 

  • Schwarz A, Maeda A, Kernebeck K, vanSteeg H, Beissert S, Schwarz T (2005) Prevention of UV radiation induced immunosuppression by IL-12 is dependent on DNA repair. J Exp Med 201:173–179

    Article  PubMed  CAS  Google Scholar 

  • Segal AR, Doherty KM, Legott J, Zlotoff B (2007) Cutaneous reactions to drugs in children. Pediatrics 120(4):e1082–e1096

    Article  PubMed  Google Scholar 

  • Senechal B, Elain G, Jeziorski E, Grondin V, Patey-Mariaud de Serre N, Jaubert F, Beldjord K, Lellouch A, Glorion C, Zerah M, Mary P, Barkaoui M, Emile JF, Boccon-Giboud L, Josset P, Debré M, Fischer A, Donadieu J, Geissman F (2007) Expansion of regulatory T cells in patients with Langerhans cell hystiocytosis. PLoS Med 4(8):1374–1384 (e253.doi:10.1371/journal.pmed.0040253)

    Article  CAS  Google Scholar 

  • Serbina NV, Pamer EG (2006) Monocyte emigration from bone marrow during bacterial infection requires signals mediated by chemokine receptor CCR2. Nat Immunol 7:311–317

    Article  PubMed  CAS  Google Scholar 

  • Stein KR, Scheinfeld NS (2007) Drug-induced photoallergic and phototoxic reactions. Expert Opin Drug Saf 6:431–443

    Article  PubMed  CAS  Google Scholar 

  • Steinman RM, Bancherau J (2007) Taking dendritic cells into medicine. Nature 449:419–426

    Article  PubMed  CAS  Google Scholar 

  • Steinman RM, Nussenzweig MC (2002) Avoiding horror autotoxicus: The importance of dendritic cells in peripheral T cell tolerance. Proc Nat Acad Sci USA 99:351–358

    Article  PubMed  CAS  Google Scholar 

  • Stoitzner P, Tripp CH, Eberhart A, Price KM, Jung JY, Bursch LS, Ronchesse F, Romani N (2006) Langerhans cells cross-present antigen derived from skin. Proc Natl Acad Sci USA 103:7783– 7788

    Article  PubMed  CAS  Google Scholar 

  • Sullivan JR, Shear NH (2002) Drug eruptions and other adverse drug effects in aged skin. Clin Geriatr Med 18:21–42

    Article  PubMed  Google Scholar 

  • Tan EK, Grattan CE (2004) Drug — induced urticaria. Expert Opin Drug Saf 3:471–484

    Article  PubMed  CAS  Google Scholar 

  • Thomas JA, Biggerstaff M, Sloane JP, Easton DF (1984) Immunological and histochemical analysis of regional variations of epidermal Langerhans cells in normal human skin. Histochem J 16:507–519

    Article  PubMed  CAS  Google Scholar 

  • Uetrecht J (2005) Role of drug metabolism for breaking tolerance and the localization of drug hypersensitivity. Toxicology 209:113–118

    Article  PubMed  CAS  Google Scholar 

  • Uetrecht J (2008) Idiosyncratic drug reactions: past, present and future. Chem Res Toxicol 21: 84–92

    Article  PubMed  CAS  Google Scholar 

  • Uzan-Gafsou S, Bausinger H, Proamer F, Monier S, Lipsker D, Cazenave JP, Goud B, deLa SH, Hanau D, Salamero J (2007) Rab11A controls the biogenesis of Birbeck granules by regulating langerin recycling and stability. Mol Biol Cell 18:3169–3179

    Article  PubMed  CAS  Google Scholar 

  • Uzinsky ST, Hertl M (2001) Novel therapeutic approaches in autoimmune skin disorders. In: Au-toimune diseases of the skin. Pathogenesis, diagnosis and management. Springer Verlag, USA, pp. 337–364

    Google Scholar 

  • Valeyrie-Allanore L, Sassolas B, Roujeau JC (2007). Drug-induced skin, nail and hair disorders. Drug Saf 30:1011–1030

    Article  PubMed  CAS  Google Scholar 

  • Verdijk P, Dijkman R, Plasmeijer EI, Mulder AA, Zoutman WH, Mommaas AM, Tensen CP (2005) A lack of Birbeck granules in Langerhans cells is associated with a naturally occurring point mutation in the human Langerin gene. J Invst Dermatol 124:714–717

    Article  CAS  Google Scholar 

  • WHO (2007) International Statistical classification of diseases and related health problems. External causes of morbility and mortality (V01-Y98). Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59). 10th edn. WHO, 2007. In: http://www.who.int/classifications/apps/icd10online Accessed on March 10th, 2008

  • Yawalkar N (2005) Drug-induced exanthems. Toxicology 209:131–134

    Article  PubMed  CAS  Google Scholar 

  • Zaccara G, Franciotta D, Perucca E (2007) Idiosyncratic adverse reactions to antiepileptic drugs. Epilepsia 48:1223–44

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacology and Tissue Cells Biology, School of Medicine, National Autonomous University of Mexico, Mexico

    Maria Dolores Ramírez-González, Miguel Herrera-Enríquez, Luisa Geraldine Villanueva-Rodríguez & Andres Eliu Castell-Rodríguez

Authors
  1. Maria Dolores Ramírez-González
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miguel Herrera-Enríquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luisa Geraldine Villanueva-Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andres Eliu Castell-Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Dolores Ramírez-González .

Editor information

Editors and Affiliations

  1. DIIID, King's College, London School of Medicine, Guy's Hospital, London, UK

    Giovanna Lombardi (Professor of Human Transplant Immunology MRC Centre in Transplantation Dep. of Nephrology and Transplantation) (Professor of Human Transplant Immunology MRC Centre in Transplantation Dep. of Nephrology and Transplantation)

  2. 5th Floor Hodgkin Building, School of Biomedical and Health Sciences, King's College London, London, SE1 1UL, United Kingdom

    Yanira Riffo-Vasquez (Research Fellow The Sackler Institute of Pulmonary Pharmacology Pharmaceutical Science Division) (Research Fellow The Sackler Institute of Pulmonary Pharmacology Pharmaceutical Science Division)

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Ramírez-González, M.D., Herrera-Enríquez, M., Villanueva-Rodríguez, L.G., Castell-Rodríguez, A.E. (2009). Role of Epidermal Dendritic Cells in Drug-Induced Cutaneous Adverse Reactions. In: Lombardi, G., Riffo-Vasquez, Y. (eds) Dendritic Cells. Handbook of Experimental Pharmacology, vol 188. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-71029-5_7

Download citation

Publish with us

Policies and ethics

Search

Navigation