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epidermic necrolysis

Josiah Tatenda Masuka, Garikai Muzopambwa, Star Khoza, Dixon Chibanda
A 29-year-old Black female patient was admitted to a psychiatric ward with symptoms of major depressive disorder with psychosis. The patient was started on amitriptyline 50 mg/day and haloperidol 10 mg/day. On day 4 post-admission, the preferred first-line antidepressant, fluoxetine, became available and the patient was switched from amitriptyline to fluoxetine 20 mg/day. On the same day, the dose of haloperidol was reduced to 5 mg/day. Thirteen days post-initiation of these medications the patient became talkative, associated with emotional lability, an expansive mood, irritability and restlessness...
December 10, 2018: Drug Safety—Case Reports
Harshad Devarbhavi, Sujata Raj
While dermatologic manifestations of adverse drug reactions are frequent, drug-induced liver injury is rare. Numerous drugs are implicated in either Drug-Induced Liver Injury or Drug-Induced Skin Injury. However, concomitant Drug-Induced Liver Injury and Drug-Induced Skin Injury are uncommon, not well characterized and appear to be caused by a limited number of drugs. These are often associated with immuno-allergic or hypersensitivity features such as fever, skin rash, blisters or peeling of skin, eosinophilia, lymphadenopathy and mucositis...
December 4, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
B Garel, S Ingen-Housz-Oro, D Afriat, C Prost-Squarcioni, F Tétart, B Bensaid, C Bara Passot, M Beylot-Barry, V Descamps, S Duvert-Lehembre, S Grootenboer-Mignot, G Jeudy, A Soria, M B Valnet-Rabier, A Barbaud, F Caux, B Lebrun-Vignes
AIMS: Linear immunoglobin A (IgA) bullous dermatosis (LABD) is a rare autoimmune dermatosis considered spontaneous or drug-induced (DILAD). We assessed all DILAD cases, determined the imputability score of drugs, highlighted suspected drugs. METHODS: Data for patients with DILAD were collected retrospectively from the French Pharmacovigilance network (from 1985 to 2017) and from physicians involved in the Bullous Diseases French Study Group and the French Investigators for Skin Adverse Reactions to Drugs...
December 4, 2018: British Journal of Clinical Pharmacology
Buğra İlhan, Halil Doğan, Emine Ayça Şahin, Neşe Karslıoğlu, Özge Koçak
Flakka, as the newest member of the synthetic cathinone group, is a substance with serious cardiovascular, neurological, psychiatric, infectious effects and addictive potential. There are only a few case reports and laboratory studies in the literature and there is no dermatological side effects reported yet. We present the first Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN) overlap case after Flakka use.
November 24, 2018: American Journal of Emergency Medicine
Mayumi Ueta
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute inflammatory vesiculobullous reactions of the mucosa of the ocular surface, oral cavity, and genitals, and of the skin. Severe ocular complications (SOC) are present in about half of SJS/TEN patients diagnosed by dermatologists. We review our group's findings on the genetic predisposition for and the etiology of SJS/TEN with SOC. We suspected that abnormal innate mucosal immunity, resulting in an anomalous response to commensal bacteria that usually do not elicit such a response, contributes to the ocular surface inflammation seen in SJS/TEN with SOC...
November 1, 2018: Investigative Ophthalmology & Visual Science
Chie Sotozono, Mayumi Ueta, Norihiko Yokoi
Stevens-Johnson syndrome (SJS), and its more severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of the skin and mucous membranes. After the acute-stage damage subsides, serious visual impairment and severe dry eye remains as ocular sequelae. At the acute stage, ocular complications occur in 77% of SJS/TEN patients. In cases with pseudomembranous formation and/or epithelial defects, the risk of ocular sequelae increases. Among 13 slit-lamp microscopy images that we obtained of SJS/TEN patients at the chronic stage, the loss of corneal epithelial stem cells and severe meibomian gland involvement were found to be the most common disorders...
November 1, 2018: Investigative Ophthalmology & Visual Science
Amanda Leal Rocha, Alessandra Figueiredo De Souza, Laiz Fernandes Mendes Nunes, Nayara Dias de Souza Cunha, Célia Regina Moreira Lanza, Denise Vieira Travassos, Tarcília Aparecida da Silva
Drug-induced reactions are complications associated with high mortality and significant morbidity. Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are examples of these conditions, which are characterized by skin and mucous lesions. Here, we report a case of a 9-year-old girl who presented with blisters associated with an extensive vesicular rash and multiple ulcerations on the lips and oral cavity. A drug-induced hypersensitivity reaction to antibiotics was suspected, and a diagnosis of TEN was made...
November 26, 2018: Pediatric Dermatology
Fusheng Zhou, Xuejun Zhang
Major histocompatibility complex (MHC), also known as human leukocyte antigen (HLA) in humans, is one of the most genetically diverse regions in the genome of various species. The human MHC contains about 400 genes in a ∼7.6-Mb span located on the short arm of the chromosomal region 6p21.3. According to the NHGRI-EBI Catalog of published genome-wide association studies ( in HLA region, more than 500 associations have been identified for about 200 traits or phenotypes, including primary immune deficiencies, autoimmune diseases, susceptibility to infections, malignancies, and psychiatric conditions (Welter et al...
December 2018: Journal of Investigative Dermatology. Symposium Proceedings
Hitoshi Maemoto, Takuro Ariga, Takeaki Kusada, Joichi Heianna, Yoshihiko Manabe, Akifumi Miyakawa, Sawako Nakachi, Satoko Morishima, Shiro Iraha, Fumikiyo Ganaha, Hiroaki Masuzaki, Sadayuki Murayama
Background: Cutaneous adverse reactions are frequently induced by mogamulizumab. Cases of Stevens-Johnson syndrome, toxic epidermal necrolysis and severe photosensitivity related to mogamulizumab have been reported. This study investigated whether severe radiation-induced dermatitis occurred in patients undergoing radiotherapy after the administration of mogamulizumab for adult T-cell leukaemia/lymphoma. Methods: We retrospectively reviewed 46 courses of radiotherapy administered to 15 consecutive patients with adult T-cell leukaemia/lymphoma (acute, n = 7; lymphoma, n = 7; smouldering, n = 1) who received mogamulizumab before or during radiotherapy at three institutions between 2012 and 2017...
November 17, 2018: Japanese Journal of Clinical Oncology
Rannakoe J Lehloenya, Niita Haitembu, Wisdom Basera, Jonny Peter
No abstract text is available yet for this article.
November 15, 2018: Journal of Allergy and Clinical Immunology in Practice
Pritam Kataria, Pradip Kendre, Apurva Patel, Nahush Tahiliani, Sushant Ikhar
Acute lymphoblastic leukemia (ALL) is the most common malignancy in pediatric patients, and it is characterized by the presence of malignant lymphoblasts within the bone marrow and peripheral blood. The treatment of ALL involves induction, consolidation, reinduction, and maintenance therapy. Consolidation therapy in ALL-Berlin-Frankfurt-Münster 90 protocol involves the use of high-dose methotrexate (HDMTX, 5 g/m2 ) over 24 h as continuous infusion. The adverse effects due to HDMTX include renal dysfunction in 2%-12% patients, which can lead to increased systemic MTX exposure, leading to further myelosuppression, mucositis, hepatotoxicity, skin toxicity, and, in severe cases, multiorgan failure...
October 2018: Indian Journal of Critical Care Medicine
Dewen Yan, Youming Zhang
No abstract text is available yet for this article.
December 2018: Pharmacogenetics and Genomics
Se Hyun Choi, Mee Kum Kim, Joo Youn Oh
PURPOSE: To determine the incidence of corneal limbal stem cell deficiency (LSCD) as chronic ocular sequelae in children with Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) and analyze the factors associated with LSCD development. DESIGN: Retrospective case series. METHODS: Medical records were reviewed of pediatric patients who had been admitted to Seoul National University Hospital with SJS/TEN and diagnosed as having acute ocular involvement...
October 19, 2018: American Journal of Ophthalmology
Kathrine Balslev Skovmøller, Anette Bygum
Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is defined as an adverse reaction to continuous use of a culprit drug. The reaction resolves upon drug withdrawal. More than 50 drugs have been linked to DI-SCLE, and it is estimated, that around 20% of the SCLE cases are drug-induced. There are no diagnostic criteria, yet detection of anti-Ro/SSA antibodies combined with erosive/bullous or erythema multiforme/toxic epidermal necrolysis-like lesions, and widespread skin rash seem to be indicative of DI-SCLE...
October 8, 2018: Ugeskrift for Laeger
Ahmed I Tahseen, Neel B Patel
No abstract text is available yet for this article.
October 2018: JAAD Case Reports
Robert J Barry, Ulises Zanetto, Sai Kolli, Rupal Morjaria
A 38-year-old woman presented to casualty with bilateral red eyes associated with a recent upper respiratory tract infection. This was initially diagnosed as conjunctivitis, however systemic review revealed an erythematous facial and skin rash, mildly swollen lips and mild swallowing difficulties. The patient was referred for an urgent medical assessment, by which time she was found to have erythema affecting 54% of her body surface area and diagnosed with suspected toxic epidermal necrolysis (TEN). She rapidly deteriorated over 24 hours with a spreading blistering skin rash and airway compromise requiring urgent intubation and admission to the intensive treatment unit (ITU)...
October 12, 2018: BMJ Case Reports
Divya Seth, Deepak Kamat
Drug allergy is commonly encountered in clinical practice. It is an immunological response to a pharmaceutical agent. The clinical presentation can vary from mild cutaneous reactions to life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Diagnosis is most often clinical, but investigations such as measurement of immunoglobulin E, patch testing, and skin biopsy may be required. In patients with a known drug allergy, the offending drug should be avoided. [Pediatr Ann. 2018;47(10):e419-e425...
October 1, 2018: Pediatric Annals
Sandra Maria Barbosa Durães, Lara Trindade de Carvalho, Aline Cairo Fassin
No abstract text is available yet for this article.
September 2018: Revista da Sociedade Brasileira de Medicina Tropical
Sara Rodríguez-Martín, Elisa Martín-Merino, Victoria Lerma, Antonio Rodríguez-Miguel, Olga González, Carlos González-Herrada, Elena Ramírez, Teresa Bellón, Francisco J de Abajo
PURPOSE: To estimate the specific incidences of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) among new users of drugs frequently reported to be associated with this serious event. METHODS: We performed a case-population approach, which combined data from a registry of SJS/TEN cases from the Madrid region (numerator) during the study period 2005-2015 and a primary healthcare database from the same catchment population. The proportion of new users of drugs estimated in the primary healthcare database was stratified by calendar year, sex and age (5-year bands), and then applied to the same strata of Madrid's population census to compute the number of new users (denominator)...
October 8, 2018: European Journal of Clinical Pharmacology
Guillaume Chaby, Bénédicte Lebrun-Vignes, Cynthia Haddad, Francois Hemery, Saskia Ingen-Housz-Oro, Nicolas de Prost, Pierre Wolkenstein, Olivier Chosidow, Laurence Fardet
No abstract text is available yet for this article.
October 5, 2018: Journal of Allergy and Clinical Immunology in Practice
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