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Chonlaphat Sukasem, Chonlawat Chaichan, Thapanat Nakkrut, Patompong Satapornpong, Kanoot Jaruthamsophon, Thawinee Jantararoungtong, Napatrupron Koomdee, Suthida Sririttha, Sadeep Medhasi, Sarawut Oo-Puthinan, Ticha Rerkpattanapipat, Jettanong Klaewsongkram, Pawinee Rerknimitr, Papapit Tuchinda, Leena Chularojanamontri, Napatra Tovanabutra, Apichaya Puangpetch, Wichai Aekplakorn
The HLA-B ∗ 15:02 allele has been reported to have a strong association with carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in Thai patients. The HLA-B alleles associated with carbamazepine-induced maculopapular exanthema (MPE) and the drug reaction with eosinophilia and systemic symptoms (DRESS) among the Thai population have never been reported. The aim of the present study was to carry out an analysis of the involvement of HLA-B alleles in carbamazepine-induced cutaneous adverse drug reactions (cADRs) in the Thai population...
2018: Journal of Immunology Research
Wimonchat Tangamornsuksan, Manupat Lohitnavy
Importance: Dapsone-induced hypersensitivity syndrome (DHS) is a life-threatening adverse drug reaction. Based on available epidemiologic studies, HLA genotypes may play an important role in DHS. Objective: To assess the association between HLA-B*1301 and dapsone-induced cutaneous adverse drug reactions (cADRs). Data Sources: Human studies investigating associations between HLA-B*1301 and dapsone-induced cADRs were systematically searched without language restriction from the inception of each database until September 12, 2017, in PubMed, the Human Genome Epidemiology Network), and the Cochrane Library...
March 14, 2018: JAMA Dermatology
Jhanvi J Vaghela, Vivek N Nimbark, Bhavesh C Chavda, Hita H Mehta, Bhargav M Purohit
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, rare and life-threatening conditions, for which etiopathogenesis, as well as pharmacotherapy, is yet uncleared. A 45-year-old male patient by chance on re-exposure to Ofloxacin developed severe cutaneous adverse drug reaction (SCADR), diagnosed with toxic epidermal necrolysis. His comorbid conditions and systemic complications of TEN were lead him to death. In developing country where antibiotics especially fluoroquinolones widely prescribed, a physician should be now vigilant for such kind of SCADRs because of increasing numbers of such kind of reports...
March 2, 2018: Current Drug Safety
Lili Xu, Yueniu Zhu, Jing Yu, Mengyan Deng, Xiaodong Zhu
RATIONALE: Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. SJS in children is not common but potentially serious disease. But the epidemiology of SJS in China is not well defined. PATIENT CONCERNS: A 6-year-old boy was initially diagnosed as pneumonia admitted to hospital after admission, and the body appears red rash with blisters, skin damage, lip debaucjed, repeated high fever, and rapid progression. DIAGNOSES: SJS often results from an allergy reaction response to a range of drugs...
January 2018: Medicine (Baltimore)
B Saka, K Dzidzinyo, S Akakpo, J Téclessou, A Nouhou Diori, N Maneh, G Mahamadou, W Gnassingbé, A Abilogun-Chokki, A Mouhari-Toure, Y Ali Boubacar, K Kombaté, K Balo, K Tchangai-Walla, P Pitché
AIM: The purpose of this study was to identify risk factors associated with the severity of acute ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) in sub-Saharan Africa. PATIENTS AND METHOD: A retrospective study was carried out at the dermatology department in collaboration with the ophthalmology department for SJS/TEN patients between January 2000 and December 2016 in Lomé (Togo). The severity of acute ocular involvement was evaluated using the Power classification, and the drug eruption score was assessed using de Bastuji-Garin classification...
February 24, 2018: Annales de Dermatologie et de Vénéréologie
Gordon Parker
OBJECTIVES: To detail some serious lamotrigine side effects and their management, and raise awareness about the possible lack of quality control of some brands of lamotrigine. METHODS: A literature review is provided and some personal observations added. RESULTS: While most psychiatrists are aware of the risks of Stevens-Johnson syndrome (SJS), awareness of two other serious side effects - toxic epidermal necrosis (TEN) and drug-related eosinophilia and systemic symptoms (DRESS) - is seemingly lower...
February 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Clayton D Conner, Emily McKenzie, Cindy E Owen
INTRODUCTION: Cyclosporine therapy for Stevens-Johnson syndrome-toxic epidermal necrolysis (SJSTEN) was first reported in the literature by Renfro et al. in 1989. Herein we report an additional 4 cases of SJS-TEN treated with cyclosporine. METHODS: Case information was collected retroactively at the University of Louisville Hospital in Louisville, KY. All cases had a diagnosis of SJS or TEN by a dermatologist. All patients were ≥18 years of age and treated with cyclosporine during their admission...
January 1, 2018: Dermatology Online Journal
Dev Chahal, Maria Aleshin, Mamina Turegano, Melvin Chiu, Scott Worswick
BACKGROUND: Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are cutaneous hypersensitivityreactions that develop in response to specific triggers such as medications and certain infections. Vaccines, which undergo rigorous safety testing prior to use in humans, are a rare cause of SJS/TEN and little is known about the frequency of such events and corresponding pathogenesis. OBJECTIVE: Herein, we discuss a case of suspected TEN in a 19-year-old woman who received the meningococcal B vaccine (the first report of such an association) and conduct a systematic review of the associated literature...
January 15, 2018: Dermatology Online Journal
Victoria Mitre, Danielle S Applebaum, Yasser Albahrani, Sylvia Hsu
Fixed drug eruption (FDE) is defined as sharply demarcated erythematous patches or plaques that occur secondary to systemic exposure to a causative medication. Eruptions are deemed "fixed" because upon repeated exposure they recur at previously affected sites. Generalized bullous fixed drug eruption (GBFDE) is a rare FDE variant occurring in patients with a previous history of FDE. Given the extensive cutaneous involvement and the frequent mucosal ulcerations associated with GBFDE, it is challenging to discern these lesions from Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)...
July 15, 2017: Dermatology Online Journal
Min-Suk Yang, Ju-Young Kim, Min-Gyu Kang, Suh-Young Lee, Jae-Woo Jung, Sang-Heon Cho, Kyung-Up Min, Hye-Ryun Kang
Background/Aims: There are only a few reports on the direct costs of severe cutaneous adverse reactions (SCARs), including drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), despite the tremendous negative impact these reactions can have on patients. We estimated the direct costs of treating SCARs. Methods: Patients admitted to a tertiary teaching hospital for the treatment of SCARs from January 1, 2005 to December 31, 2010 were included...
February 23, 2018: Korean Journal of Internal Medicine
Babikir Kheiri, Nour Aljariri Alhesan, Seetharamprasad Madala, Omar Assasa, Meng Shen, Thair Dawood
Fuchs syndrome is a milder form of the Stevens-Johnson syndrome (SJS) spectrum with only mucosal involvement which can be triggered by Mycoplasma pneumonia (MP) infection. Treatment should be directed toward supportive care including ocular and mucous membrane care, fluids and nutritional support, and pain control. In addition, antibiotic and immunomodulatory treatments are discussed for this entity.
February 2018: Clinical Case Reports
Karina L Vivar, Kimberly Mancl, Lucia Seminario-Vidal
This report highlights zonisamide as a potential cause of serious cutaneous reactions as well as its cross-reactivity with other sulfonamides. Here, we present a case of SJS-TEN due to zonisamide, which was effectively treated with IVIg. Subsequently, the patient was transitioned to levetiracetam for seizure control.
February 2018: Clinical Case Reports
Kota Tachibana, Toshihisa Hamada, Hiroki Tsuchiya, Takashi Shibata, Kazuyasu Fujii, Katsuhiro Kobayashi, Keiji Iwatsuki
We report two rare cases of childhood epilepsy patients who developed ethosuximide-induced Stevens-Johnson syndrome (SJS). Unlike typical SJS, the initial eruption of both patients presented well-demarcated, infiltrating firm papules mainly on the cheeks and the extensor aspects of the arms (case 1), and multiple vesicles on the soles and oral aphthosis (case 2), which closely mimicked viral exanthema. We diagnosed both patients with ethosuximide-induced SJS, based on the dosing period and the positive results of drug-induced lymphocyte stimulation test...
February 11, 2018: Journal of Dermatology
Geneviève M Gavigan, Nordau D Kanigsberg, Michele L Ramien
We report a case of an 11-year-old female with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) overlap, most likely triggered by sulfamethoxazole-trimethoprim, who was treated with the combination of methylprednisolone, cyclosporine, and etanercept. Her condition stabilized and her skin involvement did not progress after the addition of etanercept. To our knowledge, this is the first report of etanercept for pediatric SJS/TEN.
February 1, 2018: Journal of Cutaneous Medicine and Surgery
Sayan Basu, Swapna S Shanbhag, Arjun Gokani, Richa Kedar, Chirag Bahuguna, Virender S Sangwan
PURPOSE: To describe the long-term ocular and visual morbidity in children with chronic sequelae of Stevens-Johnson Syndrome (SJS) and visual outcomes of various management strategies. DESIGN: Retrospective comparative case series. METHODS: This study included 568 eyes of 284 children with SJS who presented between 1990 and 2015. Affected eyes either received conservative therapy (n=440) or definitive management (n=128) including lid margin mucous membrane grafting (MMG), prosthetic replacement of the ocular surface ecosystem (PROSE) contact lenses, allogeneic limbal transplantation or keratoprosthesis using an algorithmic approach based on the severity of dryness and cause and extent of corneal damage...
February 5, 2018: American Journal of Ophthalmology
Fernando Calado de Oliveira Camacho, Tânia Marina Lopes Amaral, Joana Irene de Barros Mourão
Schwartz-Jampel syndrome (SJS) is a rare genetic condition that is characterized by several musculoskeletal abnormalities, such as myotonia, joint contractures, and facial dysmorphisms. Patients with this syndrome can present an anesthetic challenge, due to an increased risk of developing malignant hyperthermia (MH) and the possibility of encountering a difficult airway. Several precautions must be taken when general anesthesia is required, such as the avoidance of potential triggers for MH, continuous core temperature, and end-tidal CO2 monitoring, assuring that dantrolene is readily available...
January 2018: Saudi Journal of Anaesthesia
Nipun Verma, Shreya Singh, Gitesh Sawatkar, Virendra Singh
Sofosbuvir is an imperative drug used in treatment regimens for hepatitis C virus (HCV). It is considered relatively safe with fewer adverse effects than other treatments. Here, we report a rare and potentially serious, dermatologic, adverse effect following the use of sofosbuvir. A 35-year-old man with genotype 3-related HCV cirrhosis presented with decompensated ascites and jaundice following 7 weeks of therapy with peginterferon alpha-2a and oral ribavirin. After peginterferon withdrawal and stabilization, oral sofosbuvir and ribavirin were started; 10 days later, he developed itching over the trunk and legs, followed by multiple papules and vesicles over an erythematous base...
January 2018: Hepatology Communications
Chuang-Wei Wang, Lan-Yan Yang, Chun-Bing Chen, Hsin-Chun Ho, Shuen-Iu Hung, Chih-Hsun Yang, Chee-Jen Chang, Shih-Chi Su, Rosaline Chung-Yee Hui, See-Wen Chin, Li-Fang Huang, Yang Yu-Wei Lin, Wei-Yang Chang, Wen-Lang Fan, Chin-Yi Yang, Ji-Chen Ho, Ya-Ching Chang, Chun-Wei Lu, Wen-Hung Chung
BACKGROUND: Cytotoxic T lymphocyte-mediated (CTL-mediated) severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), are rare but life-threatening adverse reactions commonly induced by drugs. Although high levels of CTL-associated cytokines, chemokines, or cytotoxic proteins, including TNF-α and granulysin, were observed in SJS-TEN patients in recent studies, the optimal treatment for these diseases remains controversial...
February 5, 2018: Journal of Clinical Investigation
Elizabeth J Phillips, Chonlaphat Sukasem, Michelle Whirl-Carrillo, Daniel J Müller, Henry M Dunnenberger, Wasun Chantratita, Barry Goldspiel, Yuan-Tsong Chen, Bruce C Carleton, Alfred L George, Taisei Mushiroda, Teri Klein, Roseann S Gammal, Munir Pirmohamed
The variant allele HLA-B*15:02 is strongly associated with greater risk of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in patients treated with carbamazepine or oxcarbazepine. The variant allele HLA-A*31:01 is associated with greater risk of maculopapular exanthema, drug reaction with eosinophilia and systemic symptoms, and SJS/TEN in patients treated with carbamazepine. We summarize evidence from the published literature supporting these associations and provide recommendations for carbamazepine and oxcarbazepine use based on HLA genotypes...
February 2, 2018: Clinical Pharmacology and Therapeutics
Katherine J Sullivan, Meghan N Jeffres, Robert P Dellavalle, Robert Valuck, Heather D Anderson
Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and overlap syndrome (SJS-TEN) are rare, serious skin and mucosa break-down conditions frequently associated with antibiotic use. The role of nonprescription medications alone, or in combination with antibiotics in triggering SJS/TEN, is largely unknown. This study summarized data collected from patient surveys about nonprescription and antibiotic use prior to a SJS/TEN diagnosis. The survey was administered online to members of the U.S. SJS Foundation who had been diagnosed with SJS/TEN or were the parent of a child who had been diagnosed with SJS/TEN...
February 1, 2018: Antibiotics
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