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Toxic epidermal necrolysis

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https://www.readbyqxmd.com/read/28316191/-in-vivo-confocal-microscopic-observation-of-corneal-changes-in-patients-with-chronic-stevens-johnson-syndrome-or-toxic-epidermal-necrolysis
#1
T T Gao, Y Li, J Liu, Q Long
Objective: To describe corneal alterations visible on in vivo confocal microscopy in patients with debilitating ocular sequelae caused by Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Methods: Twenty-two eyes of 11 consecutive patients suffering from chronic SJS or TEN were studied using slit lamp and in vivo confocal microscopy in the Ophthalmology Outpatient Department of Peking Union Medical College Hospital from March 2014 to April 2015. Results: Dry eye with meibomian gland dysfunction (19 eyes of 10 patients, 86...
March 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28315874/multiple-drug-hypersensitivity
#2
Werner J Pichler, Yuttana Srinoulprasert, James Yun, Oliver Hausmann
Multiple drug hypersensitivity (MDH) is a syndrome that develops as a consequence of massive T-cell stimulations and is characterized by long-lasting drug hypersensitivity reactions (DHR) to different drugs. The initial symptoms are mostly severe exanthems or drug rash with eosinophilia and systemic symptoms (DRESS). Subsequent symptoms due to another drug often appear in the following weeks, overlapping with the first DHR, or months to years later after resolution of the initial presentation. The second DHR includes exanthema, erythroderma, DRESS, Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), hepatitis, and agranulocytosis...
March 18, 2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28314701/genitourinary-involvement-and-management-in-children-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#3
J P Van Batavia, D I Chu, C J Long, M Jen, D A Canning, D A Weiss
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are devastating hypersensitivity disorders that cause epidermal cell death and can affect all epidermal surfaces, including the urethra, vagina, labial and scrotal skin. Despite the well-described ocular and orofacial manifestations of SJS/TEN, there is a paucity of reports on the genitourinary (GU) symptoms and their management. Specifically, consulting services often ask the pediatric urology team if it is safe to place a urethral catheter, but there is no data in the literature to help guide management...
February 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28300888/vancomycin-associated-linear-iga-disease-mimicking-toxic-epidermal-necrolysis
#4
Amanda Regio Pereira, Luis Henrique Barbizan de Moura, Jhonatan Rafael Siqueira Pinheiro, Victor Pavan Pasin, Milvia Maria Simões E Silva Enokihara, Adriana Maria Porro
Linear IgA dermatosis is a rare subepidermal autoimmune blistering disease characterized by linear deposition of IgA along the basement membrane zone. In the last three decades, many different drugs have been associated with the drug-induced form of the disease, especially vancomycin. We report a case of vancomycin-induced linear IgA disease mimicking toxic epidermal necrolysis. The aim of this work is to emphasize the need to include this differential diagnosis in cases of epidermal detachment and to review the literature on the subject and this specific clinical presentation...
September 2016: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28296986/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-standard-reporting-and-evaluation-guidelines-results-of-a-national-institutes-of-health-working-group
#5
Emanual Maverakis, Elizabeth A Wang, Kanade Shinkai, Surakameth Mahasirimongkol, David J Margolis, Mark Avigan, Wen-Hung Chung, Jennifer Goldman, Lois La Grenade, Munir Pirmohamed, Neil H Shear, Wichittra Tassaeeyakul, Wolfram Hoetzenecker, Jettanong Klaewsongkram, Ticha Rerkpattanapipat, Wiparat Manuyakorn, Sally Usdin Yasuda, Victoria R Sharon, Andrea Sukhov, Robert Micheletti, Jeff Struewing, Lars E French, Michelle Y Cheng
Importance: Toxic epidermal necrolysis (TEN) and Stevens-Johnson Syndrome (SJS) are rare, acute, life-threatening dermatologic disorders involving the skin and mucous membranes. Research into these conditions is hampered by a lack of standardization of case reporting and data collection. Objective: To establish a standardized case report form to facilitate comparisons and maintain data quality based on an international panel of SJS/TEN experts who performed a Delphi consensus-building exercise...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28295240/pharmacogenomic-advances-in-the-prediction-and-prevention-of-cutaneous-idiosyncratic-drug-reactions
#6
Ren-You Pan, Ro-Lan Dao, Shuen-Iu Hung, Wen-Hung Chung
Cutaneous idiosyncratic drug reactions (CIDRs) are usually unpredictable, ranging from mild maculopapular exanthema (MPE) to severe cutaneous adverse drug reactions (SCARs) such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Increasing evidences suggest HLA alleles are strongly associated with drug-induced-CIDRs. The pathomechanisms for CIDRs include genetic polymorphisms affecting complex immune specific HLA/drug antigen/T cell receptor interactions and drug metabolism...
March 15, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28285784/pediatric-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-the-united-states
#7
Derek Y Hsu, Joaquin Brieva, Nanette B Silverberg, Amy S Paller, Jonathan I Silverberg
BACKGROUND: Little is known about the epidemiology of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children. OBJECTIVE: We sought to determine the morbidity, mortality, and comorbid health conditions of SJS and TEN in US children. METHODS: This was a cross-sectional study of the 2009 to 2012 Nationwide Inpatient Sample, which contains a representative 20% sample of all US hospitalizations. Sociodemographics, inflation-adjusted cost, length of stay, comorbidities, and mortality were analyzed using descriptive statistics and multivariate regression analyses...
March 9, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28280663/management-of-toxic-epidermal-necrolysis-with-plasmapheresis-and-cyclosporine-a-our-10-years-experience
#8
Giuseppe Giudice, Giulio Maggio, Loredana Bufano, Giuseppe Memeo, Michelangelo Vestita
BACKGROUND: The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy. OBJECTIVE: To share our 10 years' experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis. METHODS: In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28278336/human-leukocyte-antigen-class-i-genes-associated-with-stevens-johnson-syndrome-and-severe-ocular-complications-following-use-of-cold-medicine-in-a-brazilian-population
#9
Tais H Wakamatsu, Mayumi Ueta, Katsushi Tokunaga, Yukinori Okada, Renata R Loureiro, Karita A Costa, Juliana Maria F Sallum, José Arthur Milhomens, Chikara Inoue, Chie Sotozono, José Álvaro P Gomes, Shigeru Kinoshita
Importance: Describing the association with human leukocyte antigen (HLA) alleles could facilitate the understanding of increased risk factors for development of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in patients with severe ocular complications (SOCs). Objective: To investigate the association between HLA class I genes and cold medicine (CM)-associated SJS/TEN with SOCs. Design, Setting, and Participants: This case-control study was conducted between February 8, 2013, and August 29, 2014...
March 9, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28278317/genetics-and-stevens-johnson-syndrome-toxic-epidermal-necrolysis-what-have-we-learned
#10
James Dunn
No abstract text is available yet for this article.
March 9, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28267083/toxic-epidermal-necrolysis-like-reaction-after-hematopoietic-stem-cell-transplantation-in-children
#11
Maura Faraci, Stefano Giardino, Edoardo Lanino, Giuseppe Morreale, Emilia Ghibaudo, Monica Francesia Berta, Marco Risso, Elio Castagnola, Mimmo Ripaldi, Andrea Moscatelli, Giovanni Ghigliotti
This study report clinical course, etiology, management, and long-term outcome of children who developed toxic epidermal necrolysis-like reaction (TEN-LR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively collected children with TEN-LR occurring after allo-HSCT performed in 2 pediatric bone marrow units between 2005 and 2014. We identified 6 cases of TEN-LR of 322 patients (1.8%). Possible triggers of TEN included antibiotics, antiepileptics, antimycotics, and Mycoplasma infection...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28250622/lyell-s-syndrome-and-antimalarials-a-case-report-and-clinical-review
#12
Joana Miranda Nunes, Sofia Santareno, Lina Guerreiro, Ana Filipa Margalho
Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare, however, life-threatening mucocutaneous disorder with an epidermal detachment of a total body surface area (TBSA) of >30%. It is triggered by an idiosyncratic immune-allergic reaction to a drug, with many possible drugs implicated. Treatment success relies on early diagnosis and withdrawal of suspected/causative drug(s) and supportive care. Clinical evidence for specific therapies is still sparse. It is described a case of Lyell syndrome by sulfonamides for chemoprophylaxis of malaria...
January 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/28239770/toxic-epidermal-necrolysis-in-a-child-with-lupus-associated-pancreatitis
#13
REVIEW
Stevic Marija, Budic Ivana, Ristic Nina, Nenadic Dragan, Bokun Zlatko, Jovanovic Branislav, Pejanovic Jelena, Simic Dusica
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatological conditions that are characterized by mucosal erosions, epidermal detachments and erosions. The most common causes of SJS and TEN are drugs; other causes such as systemic lupus erythematosus (SLE), vaccinations and infections have been rarely implicated. We present the case of a 14-year-old female patient with acute pancreatitis as an initial manifestation of systemic lupus erythematosus, complicated by the toxic epidermal necrolysis with a fatal outcome...
February 26, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28225977/identifying-the-incidence-of-rash-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-patients-taking-lamotrigine-a-systematic-review-of-122-randomized-controlled-trials
#14
Romi Bloom, Kyle T Amber
Lamotrigine is an antiepileptic drug used for the treatment of epilepsy, bipolar disorder and numerous off-label uses. The development of rash significantly affects its use. The most concerning of these adverse reactions is Stevens-Johnson syndrome/toxic epidermal necrolysis. We performed a systematic review of randomized controlled trials using lamotrigine as a monotherapy to quantify the incidence of cutaneous reactions, particularly Stevens-Johnson syndrome/toxic epidermal necrolysis. Of a total of 4,364 papers regarding lamotrigine, 122 studies met our inclusion and exclusion criteria...
January 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28222222/linear-immunoglobulin-a-dermatosis-mimicking-toxic-epidermal-necrolysis-a-case-report-of-etanercept-treatment
#15
M Prieto-Barrios, V Velasco-Tamariz, F Tous-Romero, S Burillo-Martinez, C Zarco-Olivo, J L Rodriguez-Peralto, P L Ortiz-Romero
A 65-year-old pluripathological woman attended our hospital with a cutaneous eruption of sudden appearance after vancomycin treatment. She presented targetoid lesions affecting approximately 25-30% of her body surface, large erosions, with mucosal lesions and positive Nikolsky sign. Under the initial clinical suspicion of Toxic Epidermal Necrolysis (TEN), and considering recent literature of its successful use in these cases, she was treated with a single dose of anti-Tumor Necrosis Factor (anti-TNF) agent etanercept...
February 21, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28221394/sv%C3%A3-r-reaktion-av-antiepileptikum-hos-kvinna-med-ursprung-fr%C3%A3-n-asien-karbamazepininducerat-stevens%C3%A2-johnsons-syndrom-toxisk-epidermal-nekrolys-vanligare-hos-personer-med-viss-asiatisk-h%C3%A3-rkomst
#16
Stavroula Anastasopoulou, Magdalena Komuda, Benjamin Presman, Maria Karlsson, Torbjörn Tomson
Stevens-Johnson syndrome/toxic epidermal necrolysis after initiation of carbamazepine in a HLA-B*15:02 gene carrier - screening in risk patients is recommended A 32-year-old woman, adopted from Indonesia, developed Stevens-Johnsons syndrome (SJS)/toxic epidermal necrolysis (TEN) after initiating carbamazepine treatment for epilepsy. SJS and TEN are rare but life-threatening adverse effects of carbamazepine, with a 72-100% risk of occurrence in patients carrying the HLA-B*15:02 allele. The HLA-B*15:02 allele is common in several Asian groups but less prevalent in European populations...
February 21, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28205426/a-study-of-hla-b-15-02-in-9-different-chinese-ethnics-implications-for-carbamazepine-related-sjs-ten
#17
G J Ou, J Wang, X Ji, H Yu, L Jiang, L Li, Q Chen, P C Su, Z Liu
BACKGROUND: HLA-B*15:02 is a known biomarker for carbamazepine (CBZ)-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) in some ethnic populations. The US FDA recommends B*15:02 screening for Asian and other populations with a high prevalence of B*15:02 prior to treatment with CBZ to prevent drug-related SJS/TEN. MATERIALS AND METHODS: A total of 1607 blood samples were collected from volunteer blood donors who were ethnic minorities living in the Yunnan province of southwestern China, including 153 Yi, 193 Naxi, 167 Miao, 156 Lisu, 166 Derung, 211 Bai, 184 Hani, 198 Dai, and 179 Zhuang...
April 2017: HLA
https://www.readbyqxmd.com/read/28203363/an-exploratory-factor-analysis-of-the-spontaneous-reporting-of-severe-cutaneous-adverse-reactions
#18
Manfred Hauben, Eric Hung, Wen-Yaw Hsieh
BACKGROUND: Severe cutaneous adverse reactions (SCARs) are prominent in pharmacovigilance (PhV). They have some commonalities such as nonimmediate nature and T-cell mediation and rare overlap syndromes have been documented, most commonly involving acute generalized exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS), and DRESS and toxic epidermal necrolysis (TEN). However, they display diverse clinical phenotypes and variations in specific T-cell immune response profiles, plus some specific genotype-phenotype associations...
January 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28203102/the-hla-a-31-01-allele-influence-on-carbamazepine-treatment
#19
REVIEW
Vincent Lai Ming Yip, Munir Pirmohamed
Carbamazepine (CBZ) is an effective anticonvulsant that can sometimes cause hypersensitivity reactions that vary in frequency and severity. Strong associations have been reported between specific human leukocyte antigen (HLA) alleles and susceptibility to CBZ hypersensitivity reactions. Screening for HLA-B*15:02 is mandated in patients from South East Asia because of a strong association with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). HLA-A*31:01 predisposes to multiple phenotypes of CBZ hypersensitivity including maculopapular exanthema, hypersensitivity syndrome, and SJS/TEN in a range of populations including Europeans, Japanese, South Koreans and Han Chinese, although the effect size varies between the different phenotypes and populations...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28202399/the-epidemiology-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-the-uk
#20
Noel Frey, Janine Jossi, Michael Bodmer, Andreas Bircher, Susan S Jick, Christoph R Meier, Julia Spoendlin
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening mucocutaneous diseases. SJS/TEN mostly manifest as a reaction to new drug use, but little is known about their incidence and epidemiology. We conducted a large observational study on the epidemiology of SJS/TEN using data from the UK-based Clinical Practice Research Datalink. Among 551 validated SJS/TEN cases, we calculated an incidence rate of 5.76 SJS/TEN cases/million person-years between 1995 and 2013, which was consistent throughout the study period, and was highest in patients aged 1-10 years and ≥80 years...
February 12, 2017: Journal of Investigative Dermatology
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