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Toxic epidermal necrolysis

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
Xavier Tchetnya, Calypse Asangbe Ngwasiri, Tiayah Munge, Leopold Ndemnge Aminde
BACKGROUND: Toxic epidermal necrolysis (TEN) is a rare life threatening dermatological disorder characterized by extensive epidermal detachment and erosion of mucous membranes. It is typically a side effect of some medications. Nevirapine, a nonnucleoside reverse transcriptase inhibitor (NNRTI) is one of the frequently used components of highly active antiretroviral therapy (HAART). Skin rash is its common adverse reaction, usually mild and rarely progressing to TEN. Ophthalmic involvement is common as well but rarely progresses to blindness especially in the pediatric population...
March 13, 2018: BMC Pediatrics
Katelyn F Woolridge, Patrick L Boler, Brian D Lee
Toxic epidermal necrolysis (TEN) is a rare, life-threatening adverse drug reaction for which there is no standardized or consistently effective treatment. Due to a greater understanding of disease pathogenesis and the identification of tumor necrosis factor (TNF) α as a mediator of keratinocyte death, TNF-α antagonists have been used in the treatment of TEN. Specifically, infliximab and etanercept have been shown to be effective at halting disease progression. The objective of this study is to review published case reports and case series using anti-TNF-α medications in the treatment of TEN...
January 2018: Cutis; Cutaneous Medicine for the Practitioner
Marc R Matthews, Asia N Quan, Alexandra S Weir, Kevin N Foster, Daniel M Caruso
Introduction: Leaving the abdominal cavity open is a well-described and frequently utilized technique in the treatment of severe intra-abdominal sepsis. Irrigation through a negative pressure wound therapy device is a technique employed to assist in the closure of wounds as well as the reduction of bacterial contamination. Furthermore, hypochlorous acid has been found to be safe and effective in microorganismal elimination from extremity wounds. There is no literature regarding the infusion of hypochlorous solution into the abdominal cavity for intra-abdominal sepsis or mucopurulent abscesses or biofilm...
2018: Eplasty
M Dumas, C Hua, C Hotz, C Velter, T A Duong, T Maraffi, N Ortonne, S Hüe, L Fardet, N de Prost, P Wolkenstein, S Ingen-Housz-Oro, O Chosidow
Toxic epidermal necrolysis (TEN, Lyell syndrome) and Stevens-Johnson syndrome are severe cutaneous adverse reactions to drugs characterized by epidermal necrolysis (EN). However, in 15% of cases, no causative drug is identified. In these cases, other triggers such as Mycoplasma pneumoniae have been described. Furthermore, the role of lupus as triggering factor has been suggested. We report 2 cases of EN without any drug causality, revealing autoimmune diseases as a cause. This article is protected by copyright...
March 10, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Fanping Yang, Sheng-An Chen, Xiaojin Wu, Qingyuan Zhu, Xiaoqun Luo
Drug reaction with eosinophilia and systemic symptoms (DRESS) is characterised by skin rash and multivisceral involvement. The liver is the organ most frequently affected and the degree of liver function impairment often correlates with the mortality rate of DRESS. We aimed to examine the expression of cytotoxic proteins, including soluble Fas ligand (sFasL), TNF-α, granulysin, perforin, and granzyme B in the sera and skin lesions of patients with DRESS and evaluate their clinical significance. Our cohort consisted of 21 patients with DRESS and control groups including 39 patients with Stevens-Johnson syndrome/toxic epidermal necrolysis, 21 patients with maculopapular eruption, and 29 normal controls...
February 1, 2018: European Journal of Dermatology: EJD
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
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
Ziv Lahav, Mira Nasser, Tawfik Khoury
No abstract text is available yet for this article.
February 2018: Harefuah
Parul K Kathuria Goyal, Shuai Xu, Jennifer Choi
Acute graft-versus-host disease (GvHD) is a process that classically has been defined as occurring less than 100 days after stem cell transplant. When Stage IV cutaneous acute GvHD occurs outside this window, it can be difficult to distinguish clinically from toxic epidermal necrolysis (TEN). A 50-year-old man with diffuse large B-cell lymphoma who had undergone an allogeneic stem cell transplant 20 months previously was admitted for neutropenic septic shock. He developed a slowly progressing macular/papular eruption with multiple tender bullae found to be consistent with TEN-like Stage IV cutaneous acute GvHD on biopsy...
October 15, 2017: Dermatology Online Journal
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
T Baltazard, F Dhaille, S Duvert-Lehembre, C Lok, G Chaby
BACKGROUND: Linear IgA bullous dermatosis (LABD) is an autoimmune blistering skin disorder characterized by linear IgA deposits along the dermoepidermal junction. Usually idiopathic, LABD can be drug-induced. OBJECTIVE: To report the atypical characteristics of a case of trimethoprim-sulfamethoxazole-induced LABD presenting as toxic epidermal necrolysis (TEN). METHODS: A 63-year-old woman treated with trimethoprim-sulfamethoxazole for Pneumocystis jirovecii infection developed a generalized maculopapular rash with herpetiform lesions, rosette-like lesions, and tense bullae with Nikolsky sign...
August 15, 2017: Dermatology Online Journal
Julie K Nguyen, Misha V Koshelev, Bartley J Gill, Jessica Boulavsky, Abdul Hafeez Diwan, Harry Dao
Linear IgA bullous dermatosis is a rare autoimmune vesiculobullous disease characterized by linear deposition of IgA along the basement membrane zone. It is classically idiopathic, but may also arise secondary to drug exposure. A heterogeneous spectrum of clinical features has been described, including a rare, morbid variant mimicking toxic epidermal necrolysis. Herein, we present a case of vancomycin-induced linear IgA bullous dermatosis that manifested clinically as toxic epidermal necrolysis and resolved with dapsone therapy...
August 15, 2017: 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
Shaoyu Yang, Liming Wu, Xin Li, Jie Huang, Jianbo Zhong, Xueqin Chen
Crizotinib is an oral small-molecule inhibitor of anaplastic lymphoma kinase (ALK) tyrosine-kinase that has been approved for treating patients with advanced echinoderm microtubule associated protein like 4-ALK rearranged non-small-cell lung cancer (NSCLC). Toxic epidermal necrolysis (TEN) is a rare adverse event associated with crizotinib. The present study reported a case of a 75-year-old Chinese male patient with advanced NSCLC with ALK fusion, who developed TEN after 56 days of crizotinib treatment and demised due to this dermatological adverse event...
March 2018: Molecular and Clinical Oncology
Jamal Saleh Al Wakeel, Mohammed A Al Ghonaim, Abdullah Aldohayan, Saira Usama, Saad Al Obaili, Ahmad R Tarakji, Mohammad Alkhowaiter
Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1-83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
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
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