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Therapie 2019 Mar 31. Epub 2019 Mar 31.

Dermatology Department, Habib Thameur Hospital, 1089 Tunis, Tunisia.

Background: Bullous fixed drug eruption (BFDE) is a rare and particular adverse drug reaction characterized by localized or generalized blisters and erosions, which can be confused with Stevens-Johnson syndrome, toxic epidermal necrolysis, major erythema multiforme and autoimmune bullous dermatosis.

Objective: The aim of our study was to assess the epidemiological, clinical and therapeutic features and outcome of BFDE.

Methods: A retrospective and descriptive study collecting all observations of BFDE was conducted in the dermatology department of Habib Thameur Hospital in Tunisia, over an 18-year period (2000-2017). Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Apr;51(2):356-358

Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215025, Jiangsu, China.

Drug induced hypersensitivity syndrome (DIHS) is often manifested as severe systemic drug trans-reactions characterized by acute and extensive skin lesions (mostly measles-like rash), fever, enlargement of lymph nodes, multiple organ involvement (hepatitis, nephritis, and pneumonia), eosinophilia and mononucleosis,within 2-6 weeks of the application of sensitizing drugs. In the early stage of the lesion, macular papules or erythema multiforme were common, and in severe cases, exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis were also common. Most of them developed after taking allergic drugs for 2-6 weeks (average: 3 weeks). Read More

Am J Case Rep 2019 Feb 9;20:171-174. Epub 2019 Feb 9.

Department of Inernal Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia.

BACKGROUND Bronchiolitis obliterans is the term used to describe a clinical syndrome of irreversible airflow obstruction. Among the etiologies linked to this entity is the rarely reported association with Stevens-Johnson syndrome, which has had a poor outcome in most of the previously published cases. The optimum management of bronchiolitis obliterans as a complication of Stevens-Johnson syndrome is not well defined. Read More

An Bras Dermatol 2019 Jan-Feb;94(1):17-23

Division of Dermatology, Department of Internal Medicine, Universidade Estadual de Ponta Grossa, Ponta Grossa (PR), Brazil.

Background: Stevens-Johnson syndrome and toxic epidermal necrolysis are life-threatening blistering drug reactions with high incidence of ocular sequela. The term 'Epidermal Necrolysis' has been recently used to better describe the full spectrum of the disease that includes Stevens-Johnson syndrome and toxic epidermal necrolysis at opposite ends, which differ by the extent of body surface area with epidermal detachment. SCORTEN is a mortality prognosis score for 'Epidermal Necrolysis' cases that still needed validation in acquired immunodeficiency syndrome. Read More

Adv Emerg Nurs J 2019 Jan/Mar;41(1):56-64

Department of Pharmacy Services, University of Kentucky HealthCare, Lexington.

Stevens-Johnson syndrome and toxic epidermal necrolysis represent a spectrum of severe cutaneous adverse reactions that carry the potential for severe, long-term adverse effects, including death. Although medications are most commonly implicated in the development of these diseases, other factors, including infection and genetics, play a role. Management is generally supportive in nature and includes maintenance of the patient's airway, breathing, and circulation. Read More

J Eur Acad Dermatol Venereol 2019 Jan 25. Epub 2019 Jan 25.

Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France.

Treatment of erythema multiforme (EM) is not codified. We performed a systematic review of the effect of any topical or systemic treatment on time to healing and frequency of episodes with acute and chronic forms of EM in adults. Four databases (MEDLINE, CENTRAL, EMBASE and LILACS) and other sources were searched for articles published up to 20 March 2018. Read More

Yonsei Med J 2019 Feb;60(2):208-215

Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.

Purpose: Despite morbidities and fatalities, nationwide epidemiologic data for severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS), are not widely available. We aimed to investigate SCAR epidemiology over the last two decades in Korea.

Materials And Methods: We analyzed individual case safety reports (ICSRs) of SCARs in the Korea Adverse Event Reporting System from 1988 to 2013. Read More

BMC Ophthalmol 2019 Jan 18;19(1):22. Epub 2019 Jan 18.

Department of Ophthalmology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.

Background: To identity the effect of lacrimal system irrigation in the acute stage in children with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).

Methods: A retrospective review of 39 patients with SJS or TEN from 2012 to 2017 was analyzed. Patients were divided into two subgroups according to whether they received irrigation in the acute stage. Read More

Am J Med Sci 2019 Apr 4;357(4):348-351. Epub 2018 Dec 4.

Department of Critical Care Medicine, Maimonides Medical Center, Brooklyn, New York.

Allopurinol is a first line agent in treating gout, but it also carries the risk of severe side effects. Stevens-Johnson syndrome (SJS) is one of the life threatening severe cutaneous adverse reactions caused by allopurinol. The severity of the severe cutaneous adverse reactions can be categorized based upon the area of skin involvement: (1) erythema multiforme major limited to 1-2 % of the body surface area (BSA); (2) SJS involving <10% of the BSA, (3) SJS and toxic epidermal necrolysis overlap involving 10-30% of the BSA and (4) toxic epidermal necrolysis syndrome involving >30% of the BSA. Read More

Ann Otol Rhinol Laryngol 2019 Apr 11;128(4):365-368. Epub 2019 Jan 11.

2 MEEI, Boston, MA, USA.

Objective:: To describe an observed case of spontaneous regression of cholesteatoma in a patient on chronic anti-tumor necrosis factor-alpha (TNF-a) therapy and inspire further research into the role of TNF-a in cholesteatoma.

Methods:: Clinical assessment of disease in a single-patient case report.

Results:: A 49-year-old woman suffered a severe case of Stevens-Johnson syndrome when she was 12 years old, leaving her with bilateral corneal opacification and tympanic membrane perforations with extensive cholesteatoma. Read More

J Am Acad Dermatol 2019 Mar 26;80(3):608-616. Epub 2018 Oct 26.

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medical College, New York, New York. Electronic address:

Background: Severe cutaneous adverse reactions (SCARs) are frequent in inpatient oncology. Early intervention might reduce morbidity, mortality, and hospitalization costs; however, current clinical and histologic features are unreliable SCAR predictors. There is a need to identify rational markers of SCARs that could lead to effective therapeutic interventions. Read More

Prim Care Companion CNS Disord 2018 Dec 20;20(6). Epub 2018 Dec 20.

Am J Case Rep 2018 Dec 21;19:1519-1521. Epub 2018 Dec 21.

Department of Obstetrics Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

BACKGROUND Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are causes of rare but life-threatening emergencies characterized by desquamation of the skin and mucosa. As SJS most commonly presents with skin rash followed by mucosal involvement, we present a case of vulvovaginal lesions as the initial presentation with progression to SJS after re-exposure to the culprit drug. CASE REPORT A 27-year-old female with acute cystitis was given trimethoprim-sulfamethoxazole. Read More

Indian J Dermatol Venereol Leprol 2019 Jan-Feb;85(1):101-103

Department of Dermatology, Cathay General Hospital, Taipei, Taiwan.

An Bras Dermatol 2018 Nov/Dec;93(6):942-943

Medical Residency Program in Dermatology, Faculdade de Medicina de Jundiaí, Jundiaí (SP), Brazil.

Epilepsia 2018 12 26;59(12):2325-2339. Epub 2018 Nov 26.

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.

Objective: After discovering the association between the HLA-B*15:02 allele and carbamazepine-related severe cutaneous adverse reactions (SCARs), particularly in Southeastern Asian populations, clinical strategies to prevent carbamazepine-related SCARs have changed. We aimed to investigate 10-year trends in carbamazepine use and carbamazepine-related SCARs and to examine the patterns and determinants of HLA-B*15:02 screening in Taiwan.

Methods: A nationwide study was performed using Taiwan's National Health Insurance Research Database. Read More

Pediatr Dermatol 2019 Jan 26;36(1):e27-e30. Epub 2018 Nov 26.

Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Drug-induced reactions are complications associated with high mortality and significant morbidity. Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are examples of these conditions, which are characterized by skin and mucous lesions. Here, we report a case of a 9-year-old girl who presented with blisters associated with an extensive vesicular rash and multiple ulcerations on the lips and oral cavity. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13002

Pediatric Ophthalmology Unit, Niguarda Ca' Granda Metropolitan Hospital, Milan, Italy.

Rationale: Studies performed in animal models of corneal neovascularization suggested the possible efficacy of a treatment with propranolol. Corneal neovascularization is one of the most feared complications of Stevens-Johnson syndrome that frequently involves ocular surface. We report the first 2 patients with severe ocular neo-vascularization treated with different degrees of success, with propranolol eye drops. Read More

J Am Acad Dermatol 2019 Apr 3;80(4):990-997. Epub 2018 Nov 3.

Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut. Electronic address:

Background: There is increasing recognition of distinct inflammatory eruptions associated with checkpoint inhibitors. A better understanding of their severity, therapeutic response, and impact on cancer treatment is needed.

Objective: To analyze the different rashes associated with immunotherapy referred to our institution's oncodermatology clinic and inpatient consultative service and to evaluate their therapeutic response and impact on immunotherapy. Read More

Epilepsia 2018 12 5;59(12):2318-2324. Epub 2018 Nov 5.

University of Rhode Island College of Pharmacy, Kingston, Rhode Island.

Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and potentially fatal adverse skin reactions that are most commonly triggered by certain medications. One class of medications that has been highly associated with SJS/TEN reactions is antiepileptic drugs (AEDs). We sought to quantify the risk of SJS/TEN associated with AEDs as a class, as well as individual AEDs, in the United States. Read More

JAAD Case Rep 2018 Oct 12;4(9):953-955. Epub 2018 Oct 12.

University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

J Fr Ophtalmol 2018 Nov 19;41(9):830-835. Epub 2018 Oct 19.

Service d'ophtalmologie II, centre hospitalier national des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.

Purpose: To report cases of patients with severe bilateral corneal blindness and recurrent refractory perforation to keratoplasty and conventional treatment, for whom Boston keratoprosthesis (KP) was a satisfactory alternative when combined with a temporalis aponeurosis graft.

Description Of Cases: The first patient had progressive Lyell syndrome with spontaneous corneal perforation. The second had a severe graft vs. Read More

BMJ Case Rep 2018 Oct 12;2018. Epub 2018 Oct 12.

Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, Birmingham, Birmingham, UK.

A 38-year-old woman presented to casualty with bilateral red eyes associated with a recent upper respiratory tract infection. This was initially diagnosed as conjunctivitis, however systemic review revealed an erythematous facial and skin rash, mildly swollen lips and mild swallowing difficulties. The patient was referred for an urgent medical assessment, by which time she was found to have erythema affecting 54% of her body surface area and diagnosed with suspected toxic epidermal necrolysis (TEN). Read More

J Clin Pharm Ther 2019 Feb 8;44(1):115-118. Epub 2018 Oct 8.

Division of Gastroenterology and Hepatology, Department of Medicine, Cook County Health and Hospital System, Chicago, Illinois.

What Is Known And Objective: Drug-induced liver injuries (DILI) are overall rare and often associated with use of medications. Medications are also the most common aetiology of Stevens-Johnson syndrome (SJS), but SJS is seldom seen concomitantly with liver injury. Many common drugs can cause either one of these conditions; however, there are no reported cases of concomitant DILI and SJS secondary to fluoxetine. Read More

Med Sante Trop 2018 Aug;28(3):270-272

CHU Sylvanus Olympio, Lomé, Togo.

The aim of this study was to report the frequency of and reasons for dermatology admissions in Lomé (Togo) between 2005 and 2016. This retrospective study examined records from August 2005 to December 2016 from the dermatology departments of the two teaching hospitals in Lomé, Togo. During the study period, 454 (1. Read More

PLoS One 2018 7;13(9):e0203642. Epub 2018 Sep 7.

Kidney Research Center, Department of Nephrology, Change Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan.

Background: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are severe drug-induced cutaneous adverse reactions with high mortality. Acute kidney injury (AKI) was a common complication in an SJS/TEN group and noted as an independent risk factor for mortality in patients with SJS/TEN. To determine whether AKI staging can predict the outcome of patients with SJS/TEN, we compared the discriminative power of an AKI KDIGO staging system with that of SCROTEN, APACHE II, APACHE III, and SOFA. Read More

Transplant Proc 2018 Sep 13;50(7):2188-2194. Epub 2018 Mar 13.

Dr Stanisław Sakiel Burn Treatment Centre in Siemianowice Śląskie, Siemianowice Śląskie, Poland; Department of Health Science, University of Technology and Humanities in Bielsko-Biała, Bielsko-Biała, Poland.

Introduction: The placenta is an accessible source of tissues for transplantation. Placental transplants have been used in wound treatment because of the basic function of the placenta and its nutritious properties and structure.

Patients And Methods: The aim of this work is to present the clinical usage of fetal membranes, including human amnion, on the basis of the burn treatment center's experience. Read More

Dermatol Ther 2018 09 2;31(5):e12684. Epub 2018 Sep 2.

Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, California.

Toxic shock syndrome (TSS) can sometimes mimic Steven Johnsons syndrome/toxic epidermal necrolysis (SJS/TEN). Tumor necrosis factor (TNF) alpha is thought to play a role in the pathogenesis of both TSS and SJS/TEN. Etanercept, a TNF-alpha inhibitor has been recently shown to treat and decrease mortality of SJS/TEN. Read More

Melanoma Res 2018 12;28(6):491-501

Departments of Dermatology.

Bullous disorders are rare adverse events associated with anti-programmed cell death-1 (anti-PD1) therapy. This paper presents two new cases of bullous disorders under anti-PD1 therapy and systematically reviewed the literature to foster a better understanding of the presentation and pathogenesis of bullous disorders under anti-PD1. A systematic review of the literature was completed using MEDLINE, Embase, PubMed and LILACS databases. Read More

Indian J Pharmacol 2018 May-Jun;50(3):139-142

Department of Pathology, MGM Medical College, Kishanganj, Bihar, India.

Cyclooxygenase inhibitors were developed in the quest of enhanced analgesic efficacy devoid of gastric side effects. High usage of etoricoxib by prescription as well as self-administered routes has led to increasing reports of side effects and adverse reactions including dermatologic reactions in 0.1%-0. Read More

Plast Surg Nurs 2018 Jul/Sep;38(3):121-127

André Oliveira Paggiaro, PhD, is at Guarulhos University, Guarulhos, SP, Brazil. Markinokoff Lima e Silva Filho, MN, is Nursing Postgraduation Student, Programa de Pós-Graduação em Enfermagem, Guarulhos University, Guarulhos, SP, Brazil. Viviane Fernandes de Carvalho, PhD, is at Guarulhos University, Guarulhos, SP, Brazil. César Isaac, PhD, is at São Paulo University, Sao Paulo, SP, Brazil. Rolf Gemperli, PhD, is at São Paulo University, Sao Paulo, SP, Brazil.

Stevens-Johnson syndrome (SJS) is a disease that causes skin exfoliative lesions, characterized by fever, necrosis, and epidermal detachment. Biological skin substitutes may be considered interesting options for the treatment of this disease. This study aims at identifying in the literature the evidence on the current role of these biomaterials in the treatment of SJS and its related diseases. Read More

Dermatol Online J 2018 05 15;24(5). Epub 2018 May 15.

Department of Dermatology, University of California San Diego, La Jolla, California.

Severe bullous eruptions in systemic lupus erythematosus (SLE) patients include bullous SLE, Rowell syndrome, toxic epidermal necrolysis (TEN), and TEN-like eruption of acute cutaneous lupus (TEN-like ACLE). TEN-like ACLE, a rare manifestation of SLE that closely mimics TEN, can be distinguished by characteristic clinical and laboratory findings. A 27-year-old man with SLE who developed TEN-like ACLE after initiating mycophenolate mofetil for active SLE is reported. Read More

Dermatol Online J 2018 Jun 15;24(6). Epub 2018 Jun 15.

Indiana University School of Medicine, Department of Dermatology, Indianapolis, Indiana.

Stevens-Johnson syndrome is a rare adverse cutaneous drug reaction characterized by epidermal detachment of <10% body surface area with an average mortality rate of 1-5%. The mechanism of SJS is not fully understood. Nivolumab is a monoclonal antibody directed against programmed cell death-1 protein (PD-1), a receptor with immune checkpoint inhibitory and antineoplastic activities. Read More

J Clin Pharm Ther 2019 Feb 20;44(1):69-77. Epub 2018 Aug 20.

Laboratoire de Pharmacologie Médicale et Clinique (Medical and Clinical Pharmacology Laboratory), Faculté de Médecine de l'Université Paul-Sabatier (Faculty of Medicine, Paul-Sabatier University), Toulouse, France.

What Is Known And Objective: Despite the numerous studies investigating drug-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), the understanding and quantitative data in developing countries remain limited. The study aimed to describe and quantify the drug-related risk of SJS/TEN in a resource-limited context using the Vietnamese spontaneous reporting database (VSRD) of adverse drug reactions.

Methods: Spontaneous reports relating to medium- and late-onset severe cutaneous adverse reactions (MLOSCAR) and SJS/TEN recorded in the VSRD from 2010 to 2015 were retrospectively analysed. Read More

Int Immunopharmacol 2018 Oct 10;63:204-210. Epub 2018 Aug 10.

Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglung Rd., Bangkok-noi, Bangkok 10700, Thailand. Electronic address:

Phenytoin (PHE) and carbamazepine (CBZ) are first rank causative drugs that can induce drug rash with eosinophilia and systemic symptoms (DRESS) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Identification of anti-epileptic drugs as a culprit drug has been problematic; hence, in vitro tests could be promising methods to define causative drugs without clinical risk. The aim of this study is to evaluate the efficacy of lymphocyte transformation tests (LTT) and cytokine detection assays in identifying PHE and CBZ as culprit drugs. Read More

An Bras Dermatol 2018 Jul-Aug;93(4):620-621

Department of General Surgery, 306 Hospital of PLA, Beijing, China.

Adv Emerg Nurs J 2018 Jul/Sep;40(3):176-182

Department of Adult Health Nursing (Dr Davis) and College of Nursing (Mr Schafer), University of South Alabama, Mobile; and PHI Air Medical, Phoenix, Arizona (Mr Schafer).

Stevens-Johnson syndrome is a rare, yet life-threatening, delayed-type hypersensitivity reaction characterized by mucocutaneous epidermal necrolysis. Toxic epidermal necrolysis is a severe manifestation of Stevens-Johnson syndrome, defined as greater than 30% skin detachment. Stevens-Johnson syndrome with toxic epidermal necrolysis is characterized as an adverse cutaneous drug reaction and is associated with the use of sulfonamides, antiepileptics, and some classes of nonsteroidal anti-inflammatory drugs. Read More

Drug Des Devel Ther 2018 11;12:2163-2167. Epub 2018 Jul 11.

Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, The People's Republic of China,

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are a strain of small molecule inhibitors mainly used to treat the metastatic non-small cell lung cancer. Their predominant adverse effect is skin toxicity, usually manifested as acneiform rash, skin fissure, xerosis, and paronychia. Severe epidermal necrosis and exfoliation rarely occur. Read More

Lupus 2018 Oct 20;27(11):1860-1863. Epub 2018 Jul 20.

3 Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

A 60-year-old female was diagnosed with progressive systemic sclerosis and interstitial lung disease of two months' duration. The patient was treated for Raynaud phenomenon with aspirin, nifedipine, colchicine, and naproxen. Two weeks after treatment, she developed widespread erythematous patches with blistering eruptions on the face, torso, and extremities, and also had erosion on the oral mucosa. Read More

BMJ Case Rep 2018 Jul 17;2018. Epub 2018 Jul 17.

Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two related mucocutaneous disorders with different severities. Although the incidence is low, SJS and TEN are life-threatening and predominantly drug-induced conditions. There is a strong relationship between the allele and carbamazepine-induced SJS and TEN in different Southeast Asian populations. Read More

Rev Med Chil 2018 Apr;146(4):523-527

Servicio de Anatomía patológica, Hospital del Salvador, Santiago, Chile.

Toxic epidermal necrolysis (TEN) is a lethal entity, characterized by extensive epidermal necrosis and multiorgan failure. Hemophagocytic syndrome (HFS) is also a rare and lethal syndrome characterized by hyperinflammation that leads to the appearance of fever, pancytopenia, organomegaly and hemophagocytosis. The concomitance of these diseases is extremely uncommon. Read More

Acta Dermatovenerol Croat 2018 Jun;26(2):183-185

Ružica Jurakić Tončić, MD, Department of Dermatovenereology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Šalata 4, 10000 Zagreb, Croatia;

Dear Editor, There are few literature data about nevi in patients with a history of toxic epidermal necrolysis (TEN) and little recommendations for follow-up and risks of melanoma (MM). Eruptive melanocytic nevi (EMN) is a rare phenomenon that has been associated with bullous disorders, immunosuppression, and immunodeficiency, but in some cases can occur without precipitating factors (1). The etiology is largely unknown, but there is evidence that immunosuppression might play a crucial role in nevogenesis, probably due to the inability of the immune system to inhibit melanocytic (MC) proliferation (2,3). Read More

Med Sante Trop 2018 May;28(2):332-333

Service dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, 14 BP 200 Lomé, Togo.

Objective: The aim of this study was to document the profile of children with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN, also called Lyell syndrome) in hospital settings in Lomé, Togo.

Method: This descriptive retrospective study examined the records of children aged 0 to 15, seen and/or hospitalized in the dermatology department of CHU-SO Lomé and diagnosed with SJS/TEN between 2000 and 2015.

Results: Records were identified for 14 children with these diagnoses during the study period. Read More

Epilepsia 2018 07;59(7):1469-1470

Institute for Drug Research, School of Pharmacy, The Hebrew University, Jerusalem, Israel.

J Dermatol 2018 Sep 2;45(9):1080-1087. Epub 2018 Jul 2.

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

The goal of our study was to investigate the incidence of Stevens-Johnson syndrome (SJS), the frequency of SJS diagnosis, and the association between SJS and prior use of allopurinol, carbamazepine or phenytoin. This case-control study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan. Controls visited the emergency department of the same hospital for trauma or fractures (excluding burns) and used allopurinol, carbamazepine or phenytoin during the past 3 months. Read More

J Formos Med Assoc 2019 Jan 23;118(1 Pt 2):371-377. Epub 2018 Jun 23.

Taiwan Drug Relief Foundation, Taipei, Taiwan. Electronic address:

Background/purpose: Previous studies have reported that the indication and starting dose of allopurinol may be associated with the incidence of hypersensitive reactions. As allopurinol-related severe cutaneous adverse reactions (SCARs) constitute a significant proportion of drug injury relief applications in Taiwan, this study sought to examine allopurinol use and related adverse reactions through an analysis of recent drug injury relief applications.

Methods: Allopurinol-related drug injury relief applications from 1999 to 2016 were collected, and descriptive statistical methods were used to analyze recent applications dating from 2011 to 2016. Read More

Biomed Rep 2018 Jul 16;9(1):37-41. Epub 2018 May 16.

Department of Internal Medicine and Rheumatology, 'Sfanta Maria' Hospital, 011172 Bucharest, Romania.

Tumor necrosis factor inhibitors are the first biological agents used in the treatment of rheumatoid arthritis (RA) to have yielded satisfactory results in terms of clinical improvement and radiologic progression, but they are also associated with the possibility of occurrence of a number of autoimmune systemic events [drug-induced lupus (DIL), vasculitis, sarcoidosis] and localized adverse events [uveitis, psoriasis, interstitial lung disease, erythema multiforme including the major form Stevens-Johnson syndrome (SJS)]. During treatment with TNF inhibitors, many patients develop positivity for antinuclear, antihistone and anti-double stranded DNA antibodies, though only a minority of patients will develop clinical manifestations and approximately less than 1% will fulfill the classification criteria for systemic lupus erythematosus. Mucocutaneous manifestations are the most frequent manifestations of DIL following treatment with TNF inhibitors, and can be severe and occasionally difficult to differentiate from erythema multiforme/SJS. Read More

J Am Acad Dermatol 2018 10 18;79(4):e87-e88. Epub 2018 Jun 18.

Department of Dermatology, Singapore General Hospital, Singapore. Electronic address:

J Am Acad Dermatol 2018 10 18;79(4):e89. Epub 2018 Jun 18.

University of South Florida Health Morsani College of Medicine, Tampa, Florida. Electronic address: