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Haur Yueh Lee, Stephanie Fook-Chong, Hong Yi Koh, Tharmotharampillai Thirumoorthy, Shiu Ming Pang
BACKGROUND: Treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) remains controversial. OBJECTIVE: We sought to evaluate the impact of cyclosporine on hospital mortality in patients with SJS/TEN. METHODS: All patients with SJS and TEN admitted to our center from 2011 to 2014 were treated under a standardized protocol that allowed for cyclosporine therapy if the inclusion and exclusion criteria were met. Clinical data were reviewed retrospectively...
October 4, 2016: Journal of the American Academy of Dermatology
Aditi Sangwan, Hans-Raj Saini, Pankaj Sangwan, Parveen Dahiya
Stevens-Johnson syndrome (SJS) is a severe cutaneous reaction seen rarely in clinical practice. Most often, it occurs as an adverse reaction to certain drugs. When it affects children at a very young age, arrested tooth root development may also be seen. We present a case of a 13 year old boy who suffered from SJ syndrome at the age of 7 years. Incomplete root development was observed in all teeth, as demonstrated by panaromic radiography. Clinical features of this condition and its management are further discussed...
October 2016: Journal of Clinical and Experimental Dentistry
Axelle Bonhomme, Claire Poreaux, Fabienne Jouen, Jean-Luc Schmutz, Pierre Gillet, Annick Barbaud
Nigella sativa oil (NSO), extracted from the plant Nigella sativa, is traditionally used in Africa and Asia for many therapeutic properties. Thymoquinone, its main constituent, has cellular and molecular targets, with pharmacological activities proved against various diseases.(1) We report the succession of an atypical Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) overlap to NSO and bullous pemphigoid (BP). Furthermore, we review the cases of bullous cutaneous adverse drug reactions (CADRs) with traditional herbal medicines (THM)...
September 29, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Mohammad Reza Zamani, Saeed Aslani, Arash Salmaninejad, Mohammad Reza Javan, Nima Rezaei
Programmed death 1 (PD-1) and its ligands, namely PD-L1 and PD-L2, are one of the key factors responsible for inhibitory T cell signaling, mediating the mechanisms of tolerance and providing immune homeostasis. Mounting evidence demonstrates that impaired PD-1:PD-L function plays an important role in a variety of autoimmune diseases such as Type 1 diabetes (T1D), encephalomyelitis, inflammatory bowel diseases (IBD), Rheumatoid Arthritis (RA), autoimmune hepatitis (AIH), Behcet's disease (BD), myasthenia gravis (MG), autoimmune uveitis (AU), Sjögren's syndrome (SjS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), myocarditis, and ankylosing spondylitis (AS)...
September 15, 2016: Cellular Immunology
Leelawadee Techasatian, Sunee Panombualert, Rattapon Uppala, Charoon Jetsrisuparb
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe lifethreatening skin conditions. The most common cause of these manifestations is medications. Beside discontinued of the culprit drug, systemic corticosteroids were used as a primary treatment option among pediatric population. This study aimed to explore causative drugs (drug group/ latent period), treaments, complications, and treatment outcome (morbidity, mortality, length of hospital stay) of SJS and TEN in children...
September 20, 2016: World Journal of Pediatrics: WJP
T T Gao, Q Long
Stevens-Johnson syndrome(SJS)and toxic epidermal necrolysis(TEN)are life-threatening cutaneous adverse drug reactions that induce widespread epidermal necrosis. Ocular and cutaneous diseases are common chronic sequelae of SJS and TEN. Several concepts have been proposed to explain the pathogenesis of severe cutaneous adverse drug reactions. Recent advances in genetic, pharmacogenomics and immunologic studies have provided evidences of genetic predispositions, drug metabolism and cytokines related to SJS and TEN...
September 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Tanima Bose, Maria Diedrichs-Moehring, Gerhild Wildner
Understanding the immunopathogenesis of autoimmune and inflammatory diseases is a prerequisite for specific and effective therapeutical intervention. This review focuses on animal models of two common ocular inflammatory diseases, dry eye disease (DED), affecting the ocular surface, and uveitis with inflammation of the inner eye. In both diseases autoimmunity plays an important role, in idiopathic uveitis immune reactivity to intraocular autoantigens is pivotal, while in dry eye disease autoimmunity seems to play a role in one subtype of disease, Sjögren's syndrome (SjS)...
September 15, 2016: Autoimmunity Reviews
Bahram Eshraghi, Mahla Shadravan, Elham Aalami, Elias Khalili Pour
PURPOSE: To describe a patient with Schwartz Jampel vel Aberfeld syndrome (SJS) who underwent orbicularis oculi myectomy as a treatment for blepharospasm. CASE REPORT: A 4-year-old child with SJS did not respond to an injection of a single dose of botulinum toxin after one month, so orbicularis myectomy was then performed under general anesthesia. During the procedure, orbicularis vermiform movements were a useful guide for the extent of myectomy that the patient needed...
July 2016: Journal of Ophthalmic & Vision Research
Hajirah N Saeed, James Chodosh
PURPOSE OF REVIEW: Recent advances and outcomes data in the management of Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) demonstrate the need for a universal standard of care for patients admitted with the disease. RECENT FINDINGS: Amniotic membrane transplantation, aggressive topical corticosteroids, and lubrication in the acute stage are necessary to prevent or mitigate long-term ocular sequelae. If chronic ocular disease does occur, several interventions can be employed to prevent progressive vision loss and discomfort...
November 2016: Current Opinion in Ophthalmology
I Schwarz, D Bokanovic, W Aberer
The oral allergy syndrome is one of the most common form of food allergy and manifests as contact urticaria of the oral mucosa after consumption of cross reacting foods. Whereas allergic contact stomatitis often occurs due to dental materials, allergic contact cheilitis is usually a reaction due to topical therapeutics like herpes ointments or lip care products. As late type reactions are more frequent than immediate type reactions in the anogenital mucosa, contact dermatitis in this area should be identified via epicutaneous testing...
October 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Ga-Young Ban, Seun-Joo Ahn, Hye-Soo Yoo, Hae-Sim Park, Young-Min Ye
An association between drug treatment for viral infections and severe cutaneous adverse reactions has been noted. We investigated six patients diagnosed with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) after being prescribed acetaminophen for suspected viral illnesses. Multiplex analysis was performed to measure cytokine levels in sera before and after treatment. IL-2Rα levels significantly decreased during the convalescence phase. Although acetaminophen is relatively safe, the drug can trigger SJS/TEN in patients with suspected viral infections...
August 2016: Immune Network
Zahra Karami, Mehrnaz Mesdaghi, Parvaneh Karimzadeh, Mahboubeh Mansouri, Mohammad Mehdi Taghdiri, Zarrintaj Kayhanidoost, Bita Jebelli, Reza Shekarriz Foumani, Delara Babaie, Zahra Chavoshzadeh
BACKGROUND/AIM: Administration of the anticonvulsant drugs phenobarbital, phenytoin, carbamazepine and lamotrigine can be associated with severe hypersensitivity reactions. The lymphocyte transformation test (LTT) is a method to determine which drug has caused the hypersensitivity reaction. This study was done to evaluate the results of LTT in patients with delayed hypersensitivity reactions following the administration of anticonvulsants. METHODS: Twenty-four patients with hypersensitivity reactions, e...
2016: International Archives of Allergy and Immunology
M McCullough, M Burg, E Lin, D Peng, W Garner
INTRODUCTION: The diffuse epidermal exfoliation seen in Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) is similar to skin loss in second degree burns, and many of these patients are referred for treatment at burn centers. Treatment can differ markedly from center to center, and mortality can range from 25% to 70%, including a considerable morbidity. However, our experience over a 15-year period from 2000 to 2015 with 40 patients found a mortality rate of only 10% (4/40)...
August 20, 2016: Burns: Journal of the International Society for Burn Injuries
Wiparat Manuyakorn, Surakameth Mahasirimongkol, Plernpit Likkasittipan, Wasu Kamchaisatian, Sukanya Wattanapokayakit, Wimala Inunchot, Anannit Visudtibhan, Nuanjun Wichukchinda, Suwat Benjaponpitak
OBJECTIVE: Phenobarbital hypersensitivity is one of the common drug hypersensitivity syndromes in children. Clinical symptoms of phenobarbital hypersensitivity vary from maculopapular rashes (MPs) to severe cutaneous adverse drug reactions (SCARs) including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Drug hypersensitivity has been demonstrated to be associated with variations in the HLA genotypes...
October 2016: Epilepsia
Mona-Rita Yacoub, Alvise Berti, Corrado Campochiaro, Enrico Tombetti, Giuseppe Alvise Ramirez, Andrea Nico, Elisabetta Di Leo, Paola Fantini, Maria Grazia Sabbadini, Eustachio Nettis, Giselda Colombo
Drug induced exfoliative dermatitis (ED) are a group of rare and severe drug hypersensitivity reactions (DHR) involving skin and usually occurring from days to several weeks after drug exposure. Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the main clinical presentations of drug induced ED. Overall, T cells are the central player of these immune-mediated drug reactions. Here we provide a systematic review on frequency, risk factors, pathogenesis, clinical features and management of patients with drug induced ED...
2016: Clinical and Molecular Allergy: CMA
Dinh Van Nguyen, Christopher Vidal, Hieu Chi Chu, Nga Thi Quynh Do, Tu Linh Tran, Huong Thi Minh Le, Richard B Fulton, Jamma Li, Suran L Fernando
OBJECTIVES: Screening for the HLA-B∗15:02 allele has been recommended to prevent carbamazepine (CBZ) - induced Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) in individuals with Asian ancestry. We aimed, therefore, to develop and validate a robust and inexpensive method for detection of the HLA-B∗15:02 allele. METHODS: Real-time PCR using TaqMan(®) probes followed by SYBR(®) Green was used to detect the HLA-B∗15:02 allele prior to treatment with CBZ therapy...
August 17, 2016: Human Immunology
Shoshana Israel, Nicola Maggio, Dana Ekstein, Huda Zaid, Maria Firer, Yana Bederovsky, Iris Noyman, Revital Gandelman-Marton, Ilan Blatt, Chaim Brautbar, Eli Marom, Dorit Nahlieli Dil, Erez Berman, David Sabag, Arieh Ingber, Sara Eyal
The human leukocyte antigen (HLA) alleles B*15:02 and A*31:01 have been identified as predictive markers of adverse cutaneous effects of carbamazepine and phenytoin in Asian and North European populations, respectively. Our aim was to estimate the distribution of these alleles in Jewish and Arab populations in Israel. The HLA-B*15:02 and HLA-A*31:01 carrier rate was estimated based on data from the Hadassah Bone Marrow Registry. Data on Stevens-Johnson syndrome (SJS)- and toxic epidermal necrolysis (TEN)-related hospitalizations were obtained from the Israeli Ministry of Health (MOH) registries and from four Israeli medical centers...
October 2016: Epilepsia
Takayoshi Komatsu-Fujii, Sakae Kaneko, Yuko Chinuki, Yohji Suyama, Masataka Ohta, Hiroyuki Niihara, Eishin Morita
BACKGROUND: This study aims to evaluate the relationship between serum thymus and activation-regulated chemokine (TARC) levels with various clinicopathological conditions in patients with drug eruptions. The value of TARC in diagnosing drug-induced hypersensitivity syndrome (DIHS) was also examined. METHODS: Study participants included 84 patients who presented with generalized eruptions suspected to be drug-related, including DIHS, Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), maculopapular exanthema (MPE), erythema multiforme (EM), erythroderma, and toxicoderma...
August 4, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
Diana Monteiro, Paula Egipto, Julia Barbosa, Ricardo Horta, Jose Amarante, Pedro Silva, Alvaro Silva
CONTEXT: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) corresponds to a rare and acute life-threatening mucocutaneous reactions characterized by extensive necrosis and epidermal detachment. There are no efficacious pharmaceutical interventions proven through large clinical trials. OBJECTIVE: We sought to study clinical cases admitted in our institution in order to determine which drugs and medical comorbidities or treatments impacted the mortality...
August 3, 2016: Cutaneous and Ocular Toxicology
Chonlaphat Sukasem, Thawinee Jantararoungtong, Parnrat Kuntawong, Apichaya Puangpetch, Napatrupron Koomdee, Patompong Satapornpong, Patcharin Supapsophon, Jettanong Klaewsongkram, Ticha Rerkpattanapipat
BACKGROUND: The aim of this study was to investigate the predisposition to different types of allopurinol-induced cutaneous adverse drug reactions (CADR), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN; SJS-TEN, n = 13), drug reaction with eosinophilia and systemic symptoms (DRESS, n = 10) and Maculopapular eruption (MPE; n = 7), conferred by HLA-B (*) 58:01 in a Thai population. METHODS: This case-control association study compares 30 patients with allopurinol-induced CADR, allopurinol-tolerant control patients (n = 100), and a Thai general population (n = 1095)...
2016: Frontiers in Pharmacology
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