**1. Introduction**

Since time immemorial, medications come with some benefits and risks. However the intention of treating patients to cure their ailments remains the utmost priority of all the physicians. Thus stands true, the famous dictum by Hippocrates (460–370 BC) that states "Primum non-nocere" which means first of all be sure you do no harm and benefit come next. The reality however is that at times, risk and benefit cannot be separated out so what we follow today is as long as the benefit outweighs the risk, we are ready to take risks in every walk of life similar to what we do for medicines.

Severe Cutaneous Adverse Reactions (SCARs) are drug associated hypersensitivity reactions that involves skin and mucous membranes of various body orifices such as eyes, ears, the inner surface of the nose, buccal mucosa, and lips and may involve damage to internal organs usually mediated by drug specific T lymphocytes [1, 2]. The phrase "Skin is Like an Ocean's Surface Which Tells Deep Stories If You Watch Carefully" goes very well for SCARs which is a multi-spectrum disease due to its variable manifestations. SCAR has been classified into five main types- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Drug-Induced Hypersensitivity Syndrome (DIHS), Steven Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), SJS/TEN overlap syndrome and Acute Generalized Exanthematous Pustulosis (AGEP) [3]. Severe Cutaneous Adverse Reactions (SCAR) terminology was proposed for such conditions, as they were (a) severe, (b) unpredictable, and (c) drug-induced [4]. The pathophysiology remains almost similar in all these five types of severe cutaneous adverse reactions. However, immunological trigger due to viral, drug, and gene interaction is still unknown that requires intensive research. Even the predictability, diagnosis, and treatment remains challenging and uncertain for most dermatologist, immunologists, and clinical pharmacologists.
