Activation of the immune responses in patients with MARs. (A) Flow cytometry percentages of PD1⁺ and TIGIT⁺ reactive CD4 T cells of the peripheral blood at baseline/rash/3 months (M3) in patients with and without rash. (B) Gene set enrichment analysis (GSEA) of differentially expressed genes in lesional skin of MARs compared with baseline. (C) Reactome pathway analysis of differentially expressed genes in lesional skin of MARs compared with baseline. (D) High-throughput sequencing data in skin of 2 representative patients at baseline and at the time of skin rash. The results show the recruitment of new benign T-cell clones in skin at the time of rash (all 14 patients were analyzed). *P < .05, **P < .01, ***P < .001, ****P < .0001. HD, healthy donor; IL-6, interleukin 6; mTORC1, mammalian target of rapamycin complex 1; NES, normalized enrichment score; TNFA, tumor necrosis factor alpha.