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epidermic necrolysis

Pongsathorn Kumkamthornkul, Somkiat Udnaen, Tunsuda Tansit, Papapit Tuchinda, Yuttana Srinoulprasert
Phenytoin (PHE) and carbamazepine (CBZ) are first rank causative drugs that can induce drug rash with eosinophilia and systemic symptoms (DRESS) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Identification of anti-epileptic drugs as a culprit drug has been problematic; hence, in vitro tests could be promising methods to define causative drugs without clinical risk. The aim of this study is to evaluate the efficacy of lymphocyte transformation tests (LTT) and cytokine detection assays in identifying PHE and CBZ as culprit drugs...
August 10, 2018: International Immunopharmacology
Min Diao, Christina Thapa, Xin Ran, Yuping Ran, Xiaoyan Lv
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare drug-related life-threatening acute conditions. Infection is a major cause of morbidity and mortality in these patients. The aim of this study was to analyze the infective characteristics and antimicrobial strategies in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). METHODS: 125 patients who were diagnosed with SJS/TEN in West China Hospital from 2010 to 2017 were retrospectively analyzed...
August 10, 2018: Journal of Dermatological Treatment
Andrew Hwang, Andrew Iskandar, Constantin A Dasanu
Pembrolizumab is a humanized antibody that targets programmed cell death receptor-1. This agent is approved for use in the treatment of several malignancies. While pruritus and papulo-erythematous rash are not uncommon with its use, severe reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis are very rare. We present herein a case of Stevens-Johnson syndrome occurring in a patient who had previously tolerated pembrolizumab without significant side effects for seven months. Prompt recognition of Stevens-Johnson syndrome/toxic epidermal necrolysis and discontinuation of the offending agent are paramount to ensure a favorable outcome...
August 7, 2018: Journal of Oncology Pharmacy Practice
Rodrigo Collado-Chagoya, Javier Hernández-Romero, Gumaro A Eliosa-Alvarado, Rubén A Cruz-Pantoja, Rosa I Campos-Gutiérrez, Andrea A Velasco-Medina, Guillermo Velázquez-Sámano
Tolerance induction and desensitization in Stevens-Johnson syndrome (SJS) or in toxic epidermal necrolysis (TEN) have been described as an absolute contraindication by some authors, but there are cases where there is no treatment alternative. Tuberculosis (TB) remains a leading cause of morbidity and mortality in developing countries and ranks alongside HIV as a leading cause of death worldwide. Severe drug reactions, such as SJS and TEN, occurring in these individuals are lifethreatening. Since alternative therapies for TB are limited, the role of desensitization and reintroduction becomes essential...
January 2018: Allergy & Rhinology
Olivier Gaudin, Feyrouz Toukal, Camille Hua, Nicolas Ortonne, Haudrey Assier, Arnaud Jannic, Elena Giménez-Arnau, Pierre Wolkenstein, Olivier Chosidow, Saskia Ingen-Housz-Oro
Importance: Nigella sativa oil (NSO) is widely used for cosmetic and culinary purposes. Cases of severe acute contact dermatitis due to NSO are poorly described, with no histologic description. Objectives: To describe the clinical and histologic features of severe acute contact dermatitis due to NSO and investigate the components responsible for such eruptions. Design, Setting, and Participants: A case series study of 3 patients with contact dermatitis admitted to the dermatology department between August 21, 2009, and February 19, 2017, was conducted...
August 1, 2018: JAMA Dermatology
Wesley D Davis, Phillip A Schafer
Stevens-Johnson syndrome is a rare, yet life-threatening, delayed-type hypersensitivity reaction characterized by mucocutaneous epidermal necrolysis. Toxic epidermal necrolysis is a severe manifestation of Stevens-Johnson syndrome, defined as greater than 30% skin detachment. Stevens-Johnson syndrome with toxic epidermal necrolysis is characterized as an adverse cutaneous drug reaction and is associated with the use of sulfonamides, antiepileptics, and some classes of nonsteroidal anti-inflammatory drugs. The case presented in this report is that of a 17-year-old female who presented to her primary care provider with a chief complaint of headache; she was initially diagnosed with a urinary tract infection and prescribed nitrofurantoin (Macrobid)...
July 2018: Advanced Emergency Nursing Journal
Kerasia-Maria Plachouri, Eleftheria Vryzaki, Sophia Georgiou
BACKGROUND: The introduction of Immune Checkpoint Inhibitors in the recent years has resulted in high response rates and extended survival in patients with metastatic/advanced malignancies. Their mechanism of action is the indirect activation of cytotoxic T-cells through the blockade of inhibitory receptors of immunmodulatory pathways, such as cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein-1 (PD-1) and its ligand (PD-L1). Despite their impressive therapeutic results, they can also induce immune-related toxicity, affecting various organs, including the skin...
July 29, 2018: Current Drug Safety
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: The "case-population" design has been proposed for the surveillance of rare events like Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), wherein a registry of cases is combined with sales data from the source population in order to estimate crude odds ratios (ORs). A major drawback of this method is the inability to distinguish between new and non-new users of drugs, which for the study of hypersensitivity reactions is of utmost importance. METHODS: We have explored an approach in which the exposure to the drugs of interest in the source population is inferred from a primary health care database (BIFAP), which helped us to identify drug initiators among all users and additionally adjust for potential confounders...
July 27, 2018: Pharmacoepidemiology and Drug Safety
Shang-Chen Yang, Sindy Hu, Sheng-Zheng Zhang, Jin-Wen Huang, Jing Zhang, Chao Ji, Bo Cheng
[This corrects the article DOI: 10.1155/2018/4320195.].
2018: Journal of Immunology Research
Roghayeh Talebi, Nasrin Saki, Hadi Raeisi Shahraki, Seyed Hossein Owji
The Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two ends of the spectrum of severe immunobullous state characterized by keratinocyte apoptosis. The present study aimed to draw attention to various epidemiological features of SJS and TEN diseases such as causative drugs, underlying diseases, duration of hospitalization, and types of treatment. The records of all patients with the diagnosis of SJS, TEN, and SJS/TEN overlap during 2010-2015 were retrospectively reviewed. The records belonged to patients who were admitted to the Dermatology Tertiary Referral Center of Shahid Faghihi Hospital affiliated to the Shiraz University of Medical Sciences, Shiraz, Iran...
July 2018: Iranian Journal of Medical Sciences
Lutfi Al-Kathiri, Varghese Mercyamma, Tasneem Al-Najjar
Toxic epidermal necrolysis (TEN), a severe form of Stevens-Johnson syndrome, is an acute life-threatening adverse drug reaction with a mortality rate of approximately 30%. Primary treatment of TEN is usually supportive. The use of intravenous immunoglobulin (IVIG) and corticosteroids are still uncertain, as there are only a limited number of studies comparing the usefulness of these treatments. We report a case of a Filipino male patient who developed TEN, most likely due to one of the medications he received during his course of illness...
July 2018: Oman Medical Journal
Jie Wang, XianYe Cheng, Yan Lu, BingRong Zhou
Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are a strain of small molecule inhibitors mainly used to treat the metastatic non-small cell lung cancer. Their predominant adverse effect is skin toxicity, usually manifested as acneiform rash, skin fissure, xerosis, and paronychia. Severe epidermal necrosis and exfoliation rarely occur. As one of the new generation of epidermal growth factor receptor-tyrosine kinase inhibitors, AZD-9291 is claimed to have better efficacy and fewer side effects, particularly appropriate for patients with EGFR T790M mutation...
2018: Drug Design, Development and Therapy
K Aiempanakit, K Chiratikarnwong, S Juthong, S Auepemkiate
A 60-year-old female was diagnosed with progressive systemic sclerosis and interstitial lung disease of two months' duration. The patient was treated for Raynaud phenomenon with aspirin, nifedipine, colchicine, and naproxen. Two weeks after treatment, she developed widespread erythematous patches with blistering eruptions on the face, torso, and extremities, and also had erosion on the oral mucosa. Skin biopsy for histopathology and direct immunofluorescent studies were suggestive of lupus erythematosus. To the best of our knowledge, this is the first case of toxic epidermal necrolysis-like acute cutaneous lupus erythematosus in a patient with progressive systemic sclerosis...
January 1, 2018: Lupus
Francis Capule, Pramote Tragulpiankit, Surakameth Mahasirimongkol, Nuanjun Wichukchinda, Jiraphun Jittikoon, Lara Theresa Alentajan-Aleta, Jay-V James Barit, Josephine Casanova-Gutierrez, Leonor Cabral-Lim, Jose Paciano Baltazar Reyes, Francisca Roa, Katrina Faith San Gabriel, Catherine Lynn Silao
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two related mucocutaneous disorders with different severities. Although the incidence is low, SJS and TEN are life-threatening and predominantly drug-induced conditions. There is a strong relationship between the HLA-B*1502 allele and carbamazepine-induced SJS and TEN in different Southeast Asian populations. Here, we report a case of Filipino with SJS/TEN overlap probably induced by carbamazepine. The condition was treated with hydrocortisone followed by prednisone...
July 17, 2018: BMJ Case Reports
Yilun Deng, Shaoping Li, Lin Zhang, Hou Jin, Xiaoyi Zou
PURPOSE: The aim of this study was to assess the association between human leukocyte antigen (HLA) variants and lamotrigine (LTG)-induced cutaneous adverse drug reactions (cARDs). METHODS: A comprehensive literature search was conducted on the relationship of HLA alleles with LTG-induced cADRs in Asian populations, through PubMed, Embase, and Cochrane Library. The last search was in February 2018. The pooled odds ratio (OR) with 95% confidence interval (95% CI) was used to access the strength of the association between an HLA allele and LTG-induced cADRs...
July 7, 2018: Seizure: the Journal of the British Epilepsy Association
V Lerma, M Macías, R Toro, A Moscoso, Y Alonso, O Hernández, F J de Abajo
OBJECTIVE: To describe how nursing care is delivered to patients with epidermal necrolysis in burn units/specialized units in Spain and a selection of countries. METHOD: Descriptive cross-sectional study. Data were collected through a structured questionnaire which was sent to nurse managers in all burn units in Spain and a selection of countries. Descriptive statistics was used to summarize the results. RESULTS: All BU/SUs in Spain (n=12) and seven BU/SUs from a selection of countries completed the questionnaire...
July 10, 2018: Burns: Journal of the International Society for Burn Injuries
Camila Peña, Javier Voisin, José Tomás González, Pablo Villegas
Toxic epidermal necrolysis (TEN) is a lethal entity, characterized by extensive epidermal necrosis and multiorgan failure. Hemophagocytic syndrome (HFS) is also a rare and lethal syndrome characterized by hyperinflammation that leads to the appearance of fever, pancytopenia, organomegaly and hemophagocytosis. The concomitance of these diseases is extremely uncommon. We report a 38 years old female, who during the course of a HFS secondary to Hodgkin Lymphoma (HL), presented a TEN secondary to antibiotics. She was admitted due to a consumptive syndrome, lymphadenopathy, visceromegaly and severe pancytopenia...
April 2018: Revista Médica de Chile
Anamaria Balić, Borna Pavičić, Branka Marinović, Ružica Jurakić Tončić
Dear Editor, There are few literature data about nevi in patients with a history of toxic epidermal necrolysis (TEN) and little recommendations for follow-up and risks of melanoma (MM). Eruptive melanocytic nevi (EMN) is a rare phenomenon that has been associated with bullous disorders, immunosuppression, and immunodeficiency, but in some cases can occur without precipitating factors (1). The etiology is largely unknown, but there is evidence that immunosuppression might play a crucial role in nevogenesis, probably due to the inability of the immune system to inhibit melanocytic (MC) proliferation (2,3)...
June 2018: Acta Dermatovenerologica Croatica: ADC
A Bazine, M Fetohi, T Namad, J El Benaye, M A Ennouhi, T Mahfoud, M Ichou
Vinorelbine is an anticancer agent with high clinical efficacy for the treatment of metastatic breast cancer. Toxic epidermal necrolysis is a rare but serious cutaneous adverse reaction associated with drug therapy. We hereby present a case report of a patient with metastatic breast cancer, treated with vinorelbine, who developed toxic epidermal necrolysis. To the best of our knowledge, ours is the second case report describing this exceptional dermatologic emergency associated with vinorelbine. In June 2014, a 33-year-old female was treated for localized breast cancer...
December 31, 2017: Annals of Burns and Fire Disasters
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