
Drugs & Bugs
Skin reactions to infections in children can be difficult to distinguish from reactions to medications. Children are different from adults in 2 important ways, meaning that we can’t rely on what is known about these reactions in adults without interpretation and further study. #1: Children are exposed to more infections (think of daycare) and have evolving immune responses to these bugs. #2. Adults take more medications and possibly different medications for their health conditions than children do. These differences are important because if the triggers for the reactions are different, then the treatment/management should be different and specific to children too.
In the last 5-7 years, there has been increasing recognition of the entity now preferentially referred to as RIME – reactive infectious mucocutaneous eruption – that was previously called Stevens Johnson syndrome (SJS) from infection or Mycoplasma pneumoniae-induced rash and mucositis (MIRM). This condition, a ‘bug’-related one, is triggered by many different respiratory infections but is still poorly understood. Drug-induced reactions also need further study – not only those that are blistering (toxic/drug-induced epidermal necrolysis) but other types of severe cutaneous reactions too.
The goals of the Drugs & Bugs Focused Study Group are to define and address unmet research needs in bug/infection- and drug/medication-induced skin disease in children and to advance our understanding of specific triggers, mechanisms, genetic predispositions, management, outcomes, and complications so that we can improve care for our pediatric and adolescent patients.

Chairs
The Drugs & Bugs Focused Study Group is co-chaired by Michele Ramien, MD at the University of Calgary, Minnelly Luu, MD at the University of Southern California, and Yasmine Kirkorian, MD at Children’s National Hospital.



Links
Studies Seeking Collaborators
Publications
Miller, Allison, et al. “COVID-19 associated severe mucocutaneous blistering eruptions: A case series” Pediatric Dermatology (2023).
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