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Toxic epidermal necrolysis

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https://www.readbyqxmd.com/read/28626936/a-pilot-study-comparing-histological-and-immunophenotypic-patterns-in-stage-4-skin-graft-versus-host-disease-from-toxic-epidermal-necrolysis
#1
Haley Naik, Stephen Lockwood, Arturo Saavedra
Since the inception of bone marrow transplantation, clinicians have sought to distinguish stage 4 skin graft versus host disease (GVHD) from toxic epidermal necrolysis (TEN).(1-3) In certain contexts, it can be difficult to discern among these two entities, both clinically and histologically. However, the distinction is critical because both diseases can be life-threatening and their respective management and prognosis differ.
June 19, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28618376/association-between-the-hla-b-alleles-and-carbamazepine-induced-sjs-ten-a-meta-analysis
#2
REVIEW
Qianyu Wang, Shusen Sun, Meng Xie, Kun Zhao, Xingang Li, Zhigang Zhao
PURPOSE: From our current understanding, the association between the human leukocyte antigen (HLA), HLA-B*1502, and carbamazepine(CBZ)-induced Stevens-Jonson syndrome and toxic epidermal necrolysis (SJS/TEN) in the Asian population is quite clear. However the relationship between other HLA-B alleles and CBZ-induced severe cutaneous adverse drug reactions (SCADRs) remains unclear. We aimed to identify other non-HLA-B*1502 alleles in patients with CBZ-induced SCADRs through a meta-analysis...
June 3, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28611628/overlapping-dress-and-stevens-johnson-syndrome-case-report-and-review-of-the-literature
#3
Aneline Casagranda, Mariano Suppa, Florence Dehavay, Véronique Del Marmol
Drug-induced severe cutaneous adverse reactions (SCARs) include acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS), and epidermal necrolysis (Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis). The identification of the causal drug is crucial in order to avoid further exposure, but making the right differential diagnosis of the type of SCAR is equally important since treatment, follow-up, and prognosis of different SCARs are not the same. These syndromes are distinct entities with different clinical, biological, and histological patterns, but sometimes the early distinction between 2 SCARs can be extremely challenging, and overlapping conditions could therefore be taken into consideration, although true overlapping SCARs are very rare when using strict diagnostic criteria (described by the RegiSCAR group)...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28580160/oxcarbazepine-induced-stevens-johnson-syndrome-a-pediatric-case-report
#4
Burçin Beken, Ceren Can, Aysegül Örencik, Nuray Can, Mehtap Yazıcıoğlu
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis are two rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions and mucous membrane erosions. Anti-epileptic drugs are highly suspected to be the causative agents. Although carbamazepine (CBZ) is the most associated anti-epileptic drug, oxcarbazepine (OXC), which is a monohydrated derivative of CBZ, is proposed to be safer because of the different metabolism of the two drugs. Herein, we report a case of SJS induced by oxcarbazepine...
June 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28576247/burn-center-care-of-patients-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#5
REVIEW
Robert Cartotto
Stevens-Johnson syndrome and toxic epidermal necrolysis are rare, life-threatening, cutaneous drug reactions. Medications are the most common cause, although an infection may be responsible. A link between genetics and certain medications has been established. Clinical diagnosis should be confirmed with biopsy. When the area of epidermal detachment approaches 30%, burn center care is advisable. An ophthalmologist should be consulted to optimize ocular care. Pharmacologic interruption has been sought but there is little consensus on the most appropriate agent and no high-quality studies have been conducted to demonstrate if any of these agents lead to improved survival...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28570299/hla-a-31-01-and-hla-b-15-02-association-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-to-carbamazepine-in-a-multiethnic-malaysian-population
#6
Amy Hui-Ping Khor, Kheng-Seang Lim, Chong-Tin Tan, Zhenli Kwan, Wooi-Chiang Tan, David Bin-Chia Wu, Ching-Ching Ng
The majority of the carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis CBZ-SJS/TEN are associated with HLA-B*15:02 in Asian populations where this allele is common. In contrast, the association with HLA-A*31:01 is only reported in Japanese and Europeans. This study aimed to further investigate the association with HLA-A*31:01 besides HLA-B*15:02 in a multiethnic Malaysian population. Twenty-eight CBZ-SJS/TEN cases and 227 CBZ-tolerant controls were recruited. Association was tested by comparing carrier frequencies of the alleles between cases and controls...
July 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28570227/stevens-johnson-syndrome-toxic-epidermal-necrolysis-overlap-induced-by-fexofenadine
#7
S L Teo, A Santosa, P L Bigliardi
No abstract text is available yet for this article.
June 2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28553132/cyp2c19-2-status-in-patients-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#8
Amanda J Laska, Marie J Han, Josh A Lospinoso, Patrick J Brown, Thomas M Beachkofsky
PURPOSE: Genetic polymorphisms have been linked to an increased predisposition to developing certain diseases. For example, patients of Han-Chinese descent carrying the HLA-B*1502 allele are at an increased risk of developing Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) if given carbamazepine. Given the complexity of in vivo drug metabolism, it is plausible that the activity of enzyme systems unrelated to specific drug metabolism may be important. Although multiple biomarkers have been identified in unique ethnic groups, there has yet to be a study investigating the presence of the slow metabolizing allele of CYP2C19, denoted CYP2C19*2, in diverse groups and the risk of developing SJS/TEN...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28549953/incidence-and-triggers-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-a-large-cancer-patient-cohort
#9
Nancy K Gillis, J Kevin Hicks, Gillian C Bell, Ashley J Daly, Peter A Kanetsky, Howard L McLeod
No abstract text is available yet for this article.
May 23, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28547534/a-cross-sectional-comparative-study-on-chronic-ocular-manifestations-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-chinese-eyes-a-15-year-case-series
#10
Loraine L W Chow, Alex L K Ng, Sharon S W Chow, Bonnie N K Choy, Kendrick C Shih, Ian Y H Wong, Johnny C Y Chan, Jimmy S M Lai
PURPOSE: To compare the chronic ocular manifestations in Stevens-Johnson syndrome and toxic epidermal necrolysis patients from a 15-year cohort. METHODS: All SJS and TEN patients admitted to our burn intensive care unit between 1999 and 2014 were invited for assessment. Slit-lamp examination was performed, and ocular condition was graded according to the Sotozono scoring System, which depended on the extent of cornea, conjunctiva and lid involvement. Tear osmolarity was also measured...
May 25, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28526303/the-use-of-biobrane-%C3%A2-for-wound-coverage-in-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#11
Alan D Rogers, Erin Blackport, Robert Cartotto
INTRODUCTION: Published experience describing the use of Biobrane(®) for wound management in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS-TEN) is limited to case reports and case series involving ten or fewer patients. We have used Biobrane(®) in the care of SJS-TEN since 2000, and the purpose of this study was to review our experience with the application of Biobrane(®) for wound coverage in SJS-TEN. METHODS: A retrospective review of all cases of SJS-TEN admitted to an adult regional ABA-verified burn center between January 1, 2000 and June 1, 2015 was conducted...
May 16, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28522775/purpura-fulminans-mimicking-toxic-epidermal-necrolysis-additional-value-of-16s-rrna-sequencing-and-skin-biopsy
#12
K H W Dautzenberg, F N Polderman, R J van Suylen, M A M Moviat
Both purpura fulminans and toxic epidermal necrolysis (TEN) are rare and life-threatening disorders with a high mortality. We present a case of suspected rapidly progressive, severe pneumococcal sepsis-induced purpura fulminans complicated by multiple organ failure, severe epidermolysis and cutaneous necrosis. We show the diagnostic challenge to differentiate between purpura fulminans and TEN, as the extensive epidermolysis in purpura fulminans may mimic TEN and we highlight the additional value of repeated skin biopsies and 16S rRNA gene sequencing...
May 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28515564/delayed-stevens-johnson-syndrome-secondary-to-the-use-of-lamotrigine-in-bipolar-mood-disorder
#13
Kunal Kishor Jha, Durgesh Prasad Chaudhary, Tshristi Rijal, Semanta Dahal
Lamotrigine is a mood-stabilizing drug used in maintenance treatment of bipolar I disease. There are adverse effects with lamotrigine such as a headache, blurred vision, diplopia, somnolence, ataxia, dizziness, rash, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis. SJS is a life-threatening, blistering mucocutaneous disease. SJS is characterized by the presence of flat, diffuse erythematous maculopapular rashes with the involvement of <10% of the body surface area. Standard trigger is drugs including anticonvulsants, antibiotics, and Mycoplasma pneumoniae infection...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28509689/risk-factors-of-allopurinol-induced-severe-cutaneous-adverse-reactions-in-a-thai-population
#14
Niwat Saksit, Wichittra Tassaneeyakul, Nontaya Nakkam, Parinya Konyoung, Usanee Khunarkornsiri, Pansu Chumworathayi, Chonlaphat Sukasem, Sumitra Suttisai, Napacha Piriyachananusorn, Pawinee Tiwong, Nathorn Chaiyakunapruk, Kittisak Sawanyawisuth, Ticha Rerkpattanapipat, Wongwiwat Tassaneeyakul
BACKGROUND: Allopurinol is one of the most common causes of severe cutaneous adverse drug reactions (SCARs) including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). This study identified the risk factors associated with the development of allopurinol-induced SCARs in a Thai population. PATIENTS AND METHODS: Eighty-six allopurinol-induced SCARs (i.e. 19 DRESS and 67 SJS/TEN) and 182 allopurinol-tolerant patients were enrolled in the study...
July 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28508417/score-of-toxic-epidermal-necrosis-predicts-the-outcomes-of-pediatric-epidermal-necrolysis
#15
Jennifer Sorrell, Lisa Anthony, Alfred Rademaker, Steven M Belknap, Shields Callahan, Dennis P West, Amy S Paller
BACKGROUND/OBJECTIVES: Epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis) includes immune-mediated, life-threatening inflammatory blistering disorders that can affect children. The Score of Toxic Epidermal Necrosis (SCORTEN) tool has accurately predicted the outcome of these disorders in adults but has not been tested in children. METHODS: We performed a retrospective chart review to compare the accuracy of the adult SCORTEN tool with that of two modifications tailored to children in predicting disease outcome...
May 16, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28499754/methotrexate-induced-epidermal-necrosis-a-case-series-of-24-patients
#16
Ting-Jui Chen, Wen-Hung Chung, Chun-Bing Chen, Rosaline Chung-Yee Hui, Yu-Huei Huang, Yueh-Tsung Lu, Chang-Wei Wang, Kuo-Hsien Wang, Li-Cheng Yang, Shuen-Iu Hung
BACKGROUND: Methotrexate-induced epidermal necrosis (MEN) is a rare but life-threatening cutaneous reaction that mimics Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). OBJECTIVES: To investigate the clinicopathology, risk factors, and prognostic factors of MEN. METHODS: We enrolled 24 patients with MEN and 150 controls and analyzed the demographics, pathology, and plasma concentrations of methotrexate (MTX). RESULTS: Patients with MEN showed extensive skin necrosis (mean, 33...
May 10, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28499410/comparison-of-the-acute-ocular-manifestations-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-chinese-eyes-a-15-year-retrospective-study
#17
Loraine L W Chow, Kendrick C Shih, Johnny C Y Chan, Jimmy S M Lai, Alex L K Ng
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening conditions that initially affect the skin and mucous membranes. The aim of this study was to compare the acute ocular manifestations between SJS and TEN. METHODS: The initial presenting ophthalmic records of patients with either SJS (<30% body surface area involvement) or TEN (> = 30% involvement), who were treated at one tertiary burn center in Hong Kong between 1999 and 2014, were retrospectively analyzed and compared...
May 12, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28497658/toxic-epidermal-necrolysis-in-a-child-6-months-post-hematopoietic-stem-cell-transplantation
#18
Utako Oba, Hiroshi Yamada, So-Ichi Suenobu, Yusuke Nakamura, Akiko Ito, Yutaka Hatano, Nobuyoshi Itonaga, Kouichi Ohshima, Yuhki Koga, Shouichi Ohga, Kenji Ihara
TEN is a rare and critical disease mostly caused by drugs. It is mediated by activated CD8+ T cells that cause keratinocyte apoptosis with the assistance of cytokines/chemokines. We herein report a pediatric case of TEN after allogeneic HSCT with precursor B-cell acute lymphoblastic leukemia (pre-B-ALL) in second complete remission. Although we did not evaluate the T-cell subpopulation in blood or skin lesion of the patient, an imbalanced immune reconstitution after HSCT might additively contribute to the development of TEN...
May 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28492593/eruptive-melanocytic-nevi-during-azathioprine-therapy-for-antisynthetase-syndrome
#19
Stephanie A Steinweg, Christian R Halvorson, Grace F Kao, Sridhar Dronavalli
Eruptive melanocytic nevi (EMN) are rare multiple benign melanocytic nevi that develop within a few months. The phenomenon has been associated with a variety of dermatologic and systemic conditions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, epidermolysis bullosa, Addison disease, human immunodeficiency virus infection, and internal malignancy, among others. It also is commonly attributed to medications, particularly immunosuppressive and chemotherapeutic agents. We report a case of EMN in a 50-year-old man undergoing azathioprine therapy for antisynthetase syndrome...
April 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28488978/stevens-johnson-syndrome-toxic-epidermal-necrolysis-and-treatment-with-a-biologic-a-case-report
#20
Ian Chong, Alice Chao
INTRODUCTION: One of the most dangerous dermatologic emergencies is Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN). Although a rare disease, it can often lead to significant mortality. CASE PRESENTATION: In this case report, we present a 77-year-old man who developed a sloughing rash that was secondary to a nonsteroidal anti-inflammatory drug. In addition to the recommended supportive care, the patient was treated with etanercept, a new, less commonly used intervention...
2017: Permanente Journal
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