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epidermic necrolysis

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 4, 2018: Journal of Allergy and Clinical Immunology in Practice
Morgan Gilbert, Leigh Ann Scherrer
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life threatening cutaneous reactions that are most commonly caused by exposure to medications. This review assesses the efficacy and safety of cyclosporine therapy for SJS, TEN and SJS/TEN overlap. A literature review was conducted in PubMed using the MeSH terms toxic epidermal necrolysis, Stevens-Johnson syndrome and cyclosporine. Five case series and one meta-analysis were analyzed. From review of the existing literature, cyclosporine appears to not only have a mortality benefit in the treatment of SJS/TEN, but also a relatively safe side effect profile...
October 4, 2018: Dermatologic Therapy
L Hefez, K Zaghbib, E Sbidian, L Valeyrie-Allanore, M Allain, T A Duong, A Colin, F Bellivier, H Romano, N de Prost, K Chazelas, O Chosidow, P Wolkenstein, S Ingen-Housz-Oro
BACKGROUND: Epidermal necrolysis is a rare and severe adverse cutaneous reaction to drugs with long-term somatic consequences and potentially underrecognized psychological complications. OBJECTIVES: To assess the prevalence and risk factors of post-traumatic stress disorder (PTSD) in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in a population of adults undergoing psychiatric evaluation. METHODS: In this prospective study, we included adult patients admitted at the acute phase of SJS/TEN to our dermatology department from June 2009 to February 2013...
October 3, 2018: British Journal of Dermatology
B Saka, W Gnassingbe, S Akakpo, G Mahamadou, J Teclessou, A Mouhari-Toure, K Kombaté, K Tchangaï-Walla, P Pitché
The aim of this study was to report the frequency of and reasons for dermatology admissions in Lomé (Togo) between 2005 and 2016. This retrospective study examined records from August 2005 to December 2016 from the dermatology departments of the two teaching hospitals in Lomé, Togo. During the study period, 454 (1.1%) of the 40,231 new patients who consulted in dermatology were hospitalized, with a total of 460 separate admissions (mean dermatology hospitalizations per year: 42). Patients' mean age was 43±17...
August 1, 2018: Médecine et Santé Tropicales
Han-Hee Park, Michael J Morgan, Ho Chul Kang, You-Sun Kim
Receptor-interacting protein kinase-3 (RIP3 or RIPK3) is a serine-threonine kinase largely essential for necroptotic cell death; it also plays a role in some inflammatory diseases. High levels of RIP3 are likely sufficient to activate necroptotic and inflammatory pathways downstream of RIP3 in the absence of an upstream stimulus. For example, we have previously detected high levels or RIP3 in the skin of Toxic Epidermal Necrolysis patients; this correlates with increased phosphorylation of MLKL found in these patients...
October 1, 2018: BMB Reports
Niharika Jha, Emy Alexander, Bimal Kanish, Dinesh K Badyal
Context: Cutaneous adverse drug eruptions are the most common adverse reactions attributed to drugs in which any type of skin reaction can be mimicked, induced, or aggravated. Aims: To study the pattern of various types of cutaneous adverse drug reactions (CADRs), to find out the causative drug(s) involved and to determine the response to treatment and outcome in patients with CADRs. Patients and Methods: This prospective study was done in the department of dermatology...
September 2018: Indian Dermatology Online Journal
Ryota Tanaka, Kan Yonemori, Akihiro Hirakawa, Fumie Kinoshita, Yumiko Kobayashi, Naoya Yamazaki, Manabu Fujimoto, Kenji Tamura, Yasuhiro Fujiwara
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially life-threatening cutaneous and mucosal adverse reactions to drugs. Nevertheless, the connection to anticancer agents remains unclear. To provide insight into the association of such adverse reactions with anticancer agents, we analyzed the profile of anticancer agent-induced SJS and TEN in the Japanese population. Of the 9,738 SJS/TEN events recorded in a database of spontaneous reporting data, 485 (5%, further categorized as SJS, 384 events, 79%; TEN, 101 events, 21%) were identified as anticancer agent-induced, and 53 of these (11%) were fatal...
September 25, 2018: Oncologist
Mohammad Adil, Syed Suhail Amin, Mohd Mohtashim
N-acetylcysteine is a mucolytic drug which is commonly used as an antidote for acetaminophen toxicity. It is a thiol compound, which acts as a donor of cysteine, leading to replenishment of glutathione and thus acts as an antioxidant. It also has anti-inflammatory effects, alters the levels of neurotransmitters, inhibits proliferation of fibroblasts and keratinocytes and causes vasodilatation. Due to these actions, n-acetylcysteine has found use in several dermatologic conditions in systemic and topical form...
November 2018: Indian Journal of Dermatology, Venereology and Leprology
Wimonchat Tangamornsuksan, Manupat Lohitnavy
Methazolamide-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are life-threatening adverse drug reactions. Based on previous studies, HLA genotypes may play an important role in methazolamide-induced SJS/TEN. Therefore, to identify the associations between HLA genotypes and methazolamide-induced cutaneous adverse drug reactions (cADRs) (i.e., SJS/TEN and hypersensitivity syndrome), a systematic review and meta-analysis were performed. Two studies (one study in Korean and another in Han Chinese) met the inclusion criteria...
September 21, 2018: Pharmacogenomics Journal
Liliane Borik, Peter Petzelbauer, Tamara Quint, Stefan Wöhrl, Tamar Kinaciyan, Peter Maximilian Heil
The antimalarials chloroquine and hydroxychloroquine are key medications in the long-term therapy of systemic and cutaneous lupus erythematosus, a disease characterized by a plethora of potential cutaneous manifestations. Reports on the frequency and type of dermatologic side effects of antimalarials are sparse and heterogenous, ranging from 0.1% to more than 10% of treated patients and including the very general term "cutaneous eruption" as well as dyspigmentation, alopecia, hair bleaching, pruritus, polymorphous light eruption, Stevens-Johnson syndrome and toxic epidermal necrolysis...
September 17, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Tao Han Lee, Cheng-Chia Lee, Chau-Yee Ng, Ming-Yang Chang, Su-Wei Chang, Pei-Chun Fan, Wen-Hung Chung, Ya-Chung Tian, Yung-Chang Chen, Chih-Hsiang Chang
BACKGROUND: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are severe drug-induced cutaneous adverse reactions with high mortality. Acute kidney injury (AKI) was a common complication in an SJS/TEN group and noted as an independent risk factor for mortality in patients with SJS/TEN. To determine whether AKI staging can predict the outcome of patients with SJS/TEN, we compared the discriminative power of an AKI KDIGO staging system with that of SCROTEN, APACHE II, APACHE III, and SOFA...
2018: PloS One
Nuo Xu, Xuehua Chen, Shengdi Wu, Maosong Ye, Meiling Zhang, Lin Tong, Xiaodan Zhu, Jie Liu, Feifei Hu, Chunxue Bai
Patients with toxic epidermal necrolysis (TEN) are known to experience various complications. Although pulmonary complications are commonly observed, they typically manifest in an acute form. By contrast, chronic complications are quite rare, and little is known with regard to their incidences or clinical manifestations. The present study reports the case of a 29-year-old female patient who suffered from TEN. At the onset of the disease, the patient exhibited no pulmonary impairment; however, 1 month after recovering from TEN, the patient developed severe obstruction and a mild diffusion defect...
September 2018: Experimental and Therapeutic Medicine
Keiko Hatano, Hideyuki Matsumoto, Akihiko Mitsutake, Junko Yoshimura, Aya Nomura, Sumihisa Imakado, Yukitoshi Takahashi, Hideji Hashida
We report on a 44-year-old woman who was diagnosed with toxic epidermal necrolysis (TEN) during the recovery phase from autoimmune limbic encephalitis with anti-glutamate receptor antibodies. Both, autoimmune limbic encephalitis and TEN are very rare diseases. The co-existence of the two diseases has not yet been reported. We speculate that the total of 18 drugs needed for the treatment of encephalitis might have increased the risk of TEN. Similar reports would be required to elucidate the pathophysiology of the co-existence...
May 2018: Case Reports in Neurology
Phatcharawat Chirasuthat, Pamela Chayavichitsilp
Atezolizumab is a humanized anti-PD-L1 immune checkpoint antibody that is currently used in many kinds of advanced carcinoma including metastatic non-small cell lung cancer. The cutaneous side effect profile reported only 20$ of the patients which had only mild maculopapular rash that required no treatment. There is no case report of anti-PD-L1 antibody-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) eruptions. To the best of our knowledge, there is no case report of atezolizumab-induced SJS or SJS/TEN induced by anti-PD-L1 immune checkpoint antibodies...
May 2018: Case Reports in Dermatology
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