Co-trimoxazole (CTX) causes various forms of severe cutaneous adverse reactions (SCARs). This case-control study was conducted to investigate the involvement between genetic variants of human leukocyte antigen (HLA) and CYP2C9 in CTX-induced SCARs, including Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) in Thai patients. Thirty cases of CTX-induced SCARs were enrolled and compared with 91 CTX-tolerant controls and 150 people from the general Thai population. Cases comprised 18 SJS/TEN and 12 DRESS patients. This study demonstrated that genetic association of CTX-induced SCARs was phenotype-specific. HLA-B*15:02 and HLA-C*08:01 alleles were significantly associated with CTXinduced SJS/TEN, whereas the HLA-B*13:01 allele was significantly associated with CTX-induced DRESS. In addition, a significant higher frequency of HLA-A*11:01-B*15:02 and HLA-B*13:01-C*03:04 haplotypes were detected in the group of CTX-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and DRESS cases, respectively. Genetic association of CTX-induced SCARs is phenotype-specific. Interestingly, these association was observed only in HIV-infected patients but not in non-HIV-infected patients.

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Dear Editor, Reports concerning cutaneous manifestations in coronavirus disease 2019 (COVID-19) have been mostly from temperate regions, namely Western countries and China, with prevalence rates of 0.20-20.45%. 1 Information on other races, ethnicities and locales is lacking. Thailand is located in the tropical region; thus, we hypothesize that different patterns of skin manifestations may ensue. From 9 March to 18 April 2020, 187 patients with COVID-19 were diagnosed at King Chulalongkorn Memorial Hospital, Bangkok, Thailand. We conducted a retrospective chart review and telephone interview to investigate the epidemiology of skin findings in COVID-19. This study was approved by the institutional review board of the Faculty of Medicine, Chulalongkorn University (IRB 291/63).