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Toxic epidermal necrolysis

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https://www.readbyqxmd.com/read/28430767/are-steroids-effective-in-toxic-epidermal-necrolysis-and-stevens-johnson-syndrome
#1
Rodrigo Meza, Gabriel Rada, Pablo Varas
Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe adverse skin reactions to medications and infections. Steroids are described as a therapeutic alternative, but their use is still controversial. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified four systematic reviews including 11 primary studies answering the question of interest. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach...
April 5, 2017: Medwave
https://www.readbyqxmd.com/read/28426901/a-case-of-toxic-epidermal-necrolysis-and-vanishing-bile-duct-syndrome-requiring-liver-transplantation
#2
Sophie Momen, Carol Dangiosse, Emma Wedgeworth, Sarah Walsh, Daniel Creamer
A 52-year-old woman presented with a five-day history of headache, fevers and a diffuse, macular erythematous rash. Ten days prior she received cephalexin for a urinary-tract infection. She had a history of gastro-oesophageal reflux disorder and took omeprazole. This article is protected by copyright. All rights reserved.
April 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28423957/trends-in-culprit-drugs-and-clinical-entities-in-cutaneous-adverse-drug-reactions-a-retrospective-study
#3
Fang Wang, Yu-Kun Zhao, Minyi Li, Zhe Zhu, Xingqi Zhang
PURPOSE: Morbidity due to cutaneous adverse drug reactions (CADRs) is quite common. The specific culprit drugs change over time and clinicians must be kept informed with updated knowledge, thus preventing potential CADRs. This retrospective study is a survey of CADRs encountered in a hospital-based population in Southern China during three time intervals, from 1984 to 2015. MATERIALS AND METHODS: The clinical records were review of 306 patients with CADRs who were admitted to our hospital from 2011 to 2015...
April 19, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28412864/cutaneous-allergic-drug-reactions-update-on-pathophysiology-diagnostic-procedures-and-differential-diagnostic
#4
Galina Balakirski, Hans F Merk
Important changes in the understanding and management of drug hypersensitivity reactions during the last years result from the increasing importance of biologics in medical practice, which differ in their spectrum of adverse drug reactions (ADRs) from the classical covalent drugs. With regard to covalent drugs, ampicillin and amoxicillin as well as clavulanic acid play an increasing role among ADRs to betalactam antibiotics. Fluoroquinolones are mainly the cause of anaphylactic and photosensitivity reactions...
April 17, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28411832/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-associations-outcomes-and-pathobiology-thirty-years-of-progress-but-still-much-to-be-done
#5
Robert S Stern, Sherrie J Divito
Although rare, Stevens-Johnson syndrome and toxic epidermal necrolysis remain among the most devastating of acute conditions involving the skin. In the past 30 years, tremendous progress has been made in understanding the causes and pathobiology of this often life-threatening condition. Su et al demonstrate associations between IL 15 serum levels and the outcome of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Their findings provide ideas for further investigations that may help us better understand the role of cytokines in this T-cell mediate disease and provides clues to possible new therapies...
May 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28403057/fever-in-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-pediatric-cases-laboratory-work-up-and-antibiotic-therapy
#6
Maren Paulmann, Maja Mockenhaupt
Fever is a symptom that often accompanies skin eruptions, especially in children. It can be a sign of an infectious condition presenting with exanthems or it may precede an exanthematous eruption. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe reactions affecting skin and mucosa with blisters and erosions. High fever occurs in these conditions, frequently before the skin and/or mucosa is affected.
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28401493/characterization-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-among-patients-admitted-to-kenyatta-national-hospital-a-retrospective-cross-sectional-study
#7
Kenneth Irungu, David Nyamu, Sylvia Opanga
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions. There is scant literature on the characteristics and causes of these conditions in Kenyatta National Hospital. OBJECTIVE: The aim of this study was to determine the prevalence, risk factors, and etiologies of SJS/TEN among patients admitted to Kenyatta National Hospital. METHODS: A retrospective cross-sectional study was done to find the characteristics and causes of severe cutaneous reactions among patients admitted to Kenyatta National Hospital...
April 11, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28400689/toxic-epidermal-necrolysis-and-acute-kidney-injury-due-to-glyphosate-ingestion
#8
J Indirakshi, A Sunnesh, M Aruna, M Hari Krishna Reddy, Anil C V Kumar, V Sarat Chandra, B Sangeetha, D T Katyarmal, R Ram, V Siva Kumar
The literature, particularly from India, is scarce on the renal effects of glyphosate poisoning. Glyphosate causes toxicity not only after its ingestion but also after dermal exposure by inhalation route and on eye exposure. We present a patient report of glyphosate consumption which resulted in toxic epidermal necrolysis - the first report after glyphosate consumption and acute kidney injury.
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28396847/patch-testing-and-cross-sensitivity-study-of-adverse-cutaneous-drug-reactions-due-to-anticonvulsants-a-preliminary-report
#9
T N Shiny, Vikram K Mahajan, Karaninder S Mehta, Pushpinder S Chauhan, Ritu Rawat, Rajni Sharma
AIM: To evaluate the utility of patch test and cross-sensitivity patterns in patients with adverse cutaneous drug reactions (ACDR) from common anticonvulsants. METHODS: Twenty-four (M:F = 13:11) patients aged 18-75 years with ACDR from anticonvulsants were patch tested 3-27 mo after complete recovery using carbamazepine, phenytoin, phenobarbitone, lamotrigine, and sodium valproate in 10%, 20% and 30% conc. in pet. after informed consent. Positive reactions persisting on D3 and D4 were considered significant...
March 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28395515/long-term-safety-experience-with-bendamustine-for-injection-in-a-real-world-setting
#10
Peter Martin, Paul M Barr, Leonard James, Ashutosh Pathak, Brad Kahl
BACKGROUND: Bendamustine hydrochloride (bendamustine) was approved for first-line treatment of patients with chronic lymphocytic leukemia (CLL) and relapsed indolent B-cell non-Hodgkin's lymphoma (NHL). Pharmacovigilance data have been collected since bendamustine's approval to enhance understanding of its long-term safety profile. Here we provide an overview of the pharmacovigilance data for bendamustine that have led to label updates related to safety and administration since its approval...
April 11, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28383863/-how-i-explore%C3%A2-hla-class-ii-by-ultrastructure-in-toxic-epidermal-necrolysis
#11
REVIEW
G E Piérard, A Dowlati, C Piérard-Franchimont, P Paquet, P Delvenne
Toxic epidermal necrolysis (TEN, Lyell syndrome) is a severe paroxystic drug reaction whose inductive mechanisms remain poorly understood. The HLA glycoproteins are possibly involved in the disease process. Such investigations rely on biomolecular methods, and suggest specific interactions between some drugs or their metabolites and some HLA groups according to ethnicity of the TEN patients. Electron microscopy following the immunogold method for revealing HLA-DR did not disclose any evidence for distinguishing distinct patterns on Langerhans cell membrane between the initial and the resolution phases of TEN...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28383851/-toxic-epidermal-necrolysis-lyell-syndrome-a-lifethreatening-emergency-of-introgenic-origin
#12
REVIEW
G E Piérard, S Jennes, C Piérard-Franchimont
Cutaneous drug eruptions are frequently encoun¬tered. Their putative diagnosis is based on a set of imputability arguments. The histopathological aspect is often suggestive of the dermatosis nature, and varies according to the type of drug reaction. Some drug eruptions follow a benign course, but others including the toxic epidermal necrolysis are severe and life-threatening. It corresponds to a dermatological emer¬gency to be managed in a specialized burn unit.
October 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28375199/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-childhood-onset-systemic-lupus-erythematosus-patients-a-multicenter-study
#13
Ana Paula Sakamoto, Clovis Artur Silva, Claudia Saad-Magalhães, Aline Nicácio Alencar, Rosa Maria Rodrigues Pereira, Katia Kozu, Cassia Maria Passarelli Lupoli Barbosa, Maria Teresa Terreri
OBJECTIVE: To assess Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in a large population of childhood-onset systemic lupus erythematosus (cSLE) patients. METHODS: Multicenter study including 852 cSLE patients followed in Pediatric Rheumatology centers in São Paulo, Brazil. SJS was defined as epidermal detachment below 10% of body surface area (BSA), overlap SJS-TEN 10-30% and TEN greater than 30% of BSA. RESULTS: SJS and TEN was observed in 5/852 (0...
March 26, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/28368912/toxic-epidermal-necrolysis-in-a-neurosurgical-patient
#14
Kamath Sriganesh, Badri P Dash, K V L Narasinga Rao
No abstract text is available yet for this article.
March 31, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28366923/effectiveness-safety-and-tolerability-of-cyclosporine-versus-supportive-treatment-in-stevens-johnson-syndrome-toxic-epidermal-necrolysis-a-record-based-study
#15
Swosti Mohanty, Anupam Das, Anupama Ghosh, Amrita Sil, Ramesh Chandra Gharami, Debabrata Bandyopadhyay, Nilay Kanti Das
BACKGROUND: Toxic epidermal necrolysis and Stevens-Johnson syndrome comprise life-threatening, drug-induced mucocutaneous disease spectrum. Interest in cyclosporine, a calcineurin inhibitor that can block the function of T-cells, has increased with the discovery of the importance of granulysin in apoptosis in toxic epidermal necrolysis. In our hospital, cyclosporine is given to Stevens-Johnson syndrome/toxic epidermal necrolysis patients as an adjunctive therapy. AIMS: This study is an observational, record-based study comparing the effectiveness and safety of patients receiving cyclosporine versus only supportive therapy...
March 31, 2017: Indian Journal of Dermatology, Venereology and Leprology
https://www.readbyqxmd.com/read/28362052/plasmapheresis-intravenous-immunoglobulins-and-autologous-serum-eyedrops-in-the-acute-eye-complications-of-toxic-epidermal-necrolysis
#16
Antonio Pinna, Eleonora Nuvoli, Francesco Blasetti, Maria Alma Posadinu, Francesco Boscia
PURPOSE: Toxic epidermal necrolysis (TEN) is a rare, life-threatening, drug-induced, mucocutaneous disease, which can severely affect the ocular surface. The purpose of this study was to investigate the efficacy of plasmapheresis, human IV immunoglobulins (IVIg), and autologous serum (AS) eyedrops in the treatment of the severe acute ocular complications of TEN. METHODS: A retrospective chart review of all patients admitted to the Burn Unit, Azienda Ospedaliero-Universitaria-Sassari, Sassari, Italy, from 2009 to 2015, identified 9 patients (2 men, 7 women; mean age 63...
March 21, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28358593/a-case-of-amoxicillin-induced-acute-generalized-exanthematous-pustulosis-presenting-as-septic-shock
#17
Katherine A McDonald, Tadeusz A Pierscianowski
This case report demonstrates the challenges of diagnosing and managing acute generalized exanthematous pustulosis (AGEP) presenting as septic shock. The disseminated, erythematous, pustular rash is a common feature. However, extensive organ involvement and life-threatening hypotension are unusual. The constellation of signs has not previously been documented following amoxicillin therapy. Toxic epidermal necrolysis (TEN) and toxic shock syndrome (TSS) were considered in addition to AGEP because of the systemic presentation...
March 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28351788/severe-cutaneous-adverse-drug-reactions-in-pediatric-patients-a-multicenter-study
#18
Emine Dibek Misirlioglu, Hakan Guvenir, Semiha Bahceci, Mehtap Haktanir Abul, Demet Can, Belgin Emine Usta Guc, Mustafa Erkocoğlu, Muge Toyran, Hikmet Tekin Nacaroglu, Ersoy Civelek, Betul Buyuktiryaki, Tayfur Ginis, Fazil Orhan, Can Naci Kocabas
BACKGROUND: The severe cutaneous adverse drug reactions (SCARs) are rare but could be life-threatening. These include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis. OBJECTIVE: The purpose of this study was the evaluation of the clinical characteristics of patients with the diagnosis of SCARs. METHODS: Patients who were diagnosed with SCARs between January 2011 and May 2016 by pediatric allergy clinics in the provinces of Ankara, Trabzon, Izmir, Adana, and Bolu were included in this multicenter study...
March 25, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28346659/is-universal-hla-b-15-02-screening-a-cost-effective-option-in-an-ethnically-diverse-population-a-case-study-of-malaysia
#19
H Y Chong, Z Mohamed, L L Tan, D B C Wu, F H Shabaruddin, M Dahlui, Y D Apalasamy, S R Snyder, M S Williams, J Hao, L H Cavallari, N Chaiyakunapruk
BACKGROUND: Strong association was documented between human leukocyte antigen (HLA)-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Beyond Asia, the HLA testing is potentially valuable in many countries with increasingly diverse communities of Asian ancestry, to facilitate an early recognition of patient susceptibility to SCARs. OBJECTIVE: To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/ toxic epidermal necrolysis in an ethnically-diverse Malaysian population...
March 27, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28330775/novel-interferon-%C3%AE-enzyme-linked-immunospot-assay-using-activated-cells-for-identifying-hypersensitivity-inducing-drug-culprits
#20
Kenichi Kato, Asami Kawase, Hiroaki Azukizawa, Takaaki Hanafusa, Yukinobu Nakagawa, Hiroyuki Murota, Shimon Sakaguchi, Hideo Asada, Ichiro Katayama
BACKGROUND: The drug-induced lymphocyte stimulation test (DLST), also referred to as lymphocyte transformation test (LTT), is used to identify the culprit drug in cases of cutaneous adverse drug reactions (cADR). Although DLST is a widely used in vitro test, its sensitivity and specificity are unsatisfactory. Recent reports suggest that the detection of drug-induced interferon (IFN)-γ production using enzyme-linked immunoSpot (ELISpot) assay (conventional IFN-γ ELISpot) is useful for identifying culprit drugs in cADR cases...
March 14, 2017: Journal of Dermatological Science
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