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J Dtsch Dermatol Ges 2022 06;20(6):777-786

German Center for the Documentation of Severe Skin Reactions (dZh), Department of Dermatologie, Medical Center and Medical Faculty - University of Freiburg, Germany.

Background: Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, primarily drug-induced reactions of skin and mucosa. Since they differ in the extent of skin detachment but not in etiology, they are grouped together as epidermal necrolysis (EN). Due to nationwide registration, representative data are available at the German Center for the Documentation of Severe Skin Reactions (dZh). Read More

Arerugi 2022 ;71(4):328-333

Department of Pediatrics, Kasugai Municipal Hospital.

We describe here the case of a 7-year-old male patient with Stevens-Johnson syndrome (SJS), which was suspected to be caused by treatment with tipepidine hibenzate (Asverin). The day after taking tipepidine hibenzate and L-carbocysteine (Carbocysteine DS) for relief of a cold, he began presenting with the following symptoms: fever above 38°C, wheezing, and decreased oxygen saturation. Two days later, mucous membrane rashes, such as erosions on the lips, eye mucosa, vulva, and blisters on the trunk appeared, and SJS was thus diagnosed. Read More

Pediatr Dermatol 2022 Jun 8. Epub 2022 Jun 8.

Dermatology Program, Department of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA.

Background/objectives: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous hypersensitivity reactions that carry significant morbidity and mortality. While clinical features are well documented in adult and pediatric patients, infantile cases are rarely reported. Our objective was to synthesize clinical features and outcomes in this population. Read More

Paediatr Drugs 2022 Jul 9;24(4):307-319. Epub 2022 Jun 9.

Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Pediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threating blistering diseases triggered by medications that affect the skin and mucosae. Drug-induced epidermal necrolysis is a better term for medication-triggered cases because there is a spectrum of disease severity that otherwise is divided into the separate entities of SJS, overlap SJS/TEN, and TEN. This manuscript reviews the management of drug-induced epidermal necrolysis (DEN), including diagnosis, investigations to exclude differential diagnoses, and treatment. Read More

Cutis 2022 Apr;109(4):221-223

Dr. Kou is from Des Moines University College of Osteopathic Medicine, Iowa. Dr. Kolb is from Olmsted Medical Center, Rochester, Minnesota. Dr. Kelada is from Roseville Family Healthcare, California. Dr. Schmieder is from the Department of Dermatology, Orange Park Medical Center, Florida.

Blisters and subsequent desquamation of the skin in the presence of acute edema is a well-known clinical phenomenon. In this case report, we describe a new variant that we have termed anasarca-induced desquamation in a 50-year-old man with molting of the entire cutaneous surface after acute edema, in a setting of 40-lb weight gain over 5 days. Laboratory workup for infectious causes and punch biopsies of skin lesions ruled out Stevens-Johnson syndrome and staphylococcal scalded skin syndrome, which have a similar clinical presentation to anasarca-induced desquamation. Read More

Cutis 2022 02;109(2):E9-E12

Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa.

Indian J Dent Res 2021 Oct-Dec;32(4):537-540

Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

In the present era, the use of drugs is an important paradigm of health care. Reactions to drugs range from minor cutaneous reactions to potentially lethal conditions like Stevens-Johnson syndrome. A 13-year-old, male patient, known case of Stevens-Johnson Syndrome was referred from the pediatric ward for the management of oral mucosal lesions, post consumption of the antibiotic combination of sulfamethoxazole and trimethoprim. Read More

West Afr J Med 2022 May;39(5):538-542

Service de dermatologie-vénérologie, Centre National Hospitalier et Universitaire de Cotonou, Faculté des Sciences de la Santé - Université d'Abomey-Calavi.

Background: The aim of this study was to describe the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children in dermatologyvenereology unit at National and Teaching Hospital of Cotonou.

Methods: A retrospective and descriptive study was carried out for 10 years in dermatology-venereology unit at the National and Teaching Hospital of Cotonou to document the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children. It included all children aged from 0 to 18 years with clinical diagnosis of severe cutaneous adverse drug reactions. Read More

J Invest Dermatol 2022 May 18. Epub 2022 May 18.

Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD. Electronic address:

Cutaneous immune-related adverse events (cirAEs) are the most prevalent complication to arise from immunotherapy and cause significant morbidity. We aimed to determine the spectrum, timing, clinical features, and outcomes of cirAEs by conducting an observational pharmacovigilance study using VigiBase, the World Health Organization's global database of individual case safety reports from over 130 member countries (ClinicalTrials.gov, number NCT04898751). Read More

Acta Derm Venereol 2022 05 24;102:adv00723. Epub 2022 May 24.

Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Japan.

J Eur Acad Dermatol Venereol 2022 06;36(6):764

Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

J Drugs Dermatol 2022 May;21(5):529-530

Nivolumab (anti PD-1 antibody) and ipilimumab (anti CTLA-4 antibody) are immune checkpoint inhibitors (ICI) that effectively stimulate the native T cell response and lead to an antitumor response. The medications have been approved for the treatment of metastatic melanoma. However, ICIs are associated with higher risk for cutaneous immune-related adverse events (irAEs). Read More

Actas Dermosifiliogr 2022 Mar 10;113(3):294-299. Epub 2021 Nov 10.

División de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.

Toxic epidermal necrolysis is the most serious mucocutaneous adverse drug reaction. Multidisciplinary treatment and withdrawal of the causative drug are key to reducing mortality. Few studies have analyzed the use of systemic corticosteroids and intravenous immunoglobulins (IVIG) in patients with toxic epidermal necrolysis in Latin America. Read More

Int Immunopharmacol 2022 Aug 5;109:108804. Epub 2022 May 5.

Institute of Neuroscience and Department of Neurology of the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou 510260, China. Electronic address:

Background: Previous studies have demonstrated that human leukocyte antigen (HLA)-A*24:02 is a common genetic risk factor for antiepileptic drug-induced skin rash, while HLA-B*15:02 is a specific risk factor for carbamazepine (CBZ)-induced Stevens Johnson syndrome and toxin epidermal necrolysis. The HLA-B*15:02 allele can alter the repertoire of endogenous peptides to trigger CBZ-induced hypersensitivity. However, it is uncertain whether HLA-A*24:02 could produce alterations in the peptide repertoire during treatment with antiepileptic drugs. Read More

J Dtsch Dermatol Ges 2022 05 28;20(5):687-689. Epub 2022 Apr 28.

Dermatology Unit. Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy.

BMJ Case Rep 2022 Apr 25;15(4). Epub 2022 Apr 25.

Department of Pediatrics, Osaka Red Cross Hospital, Osaka, Japan.

A young girl in her teens presented with fever, rashes and various mucocutaneous symptoms. Flat erythematous macules were seen mainly on the limbs, without blisters or skin detachments. The lips were swollen with crusts and haemorrhage. Read More

BMC Ophthalmol 2022 Apr 19;22(1):179. Epub 2022 Apr 19.

Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.

Background: Stevens-Johnson syndrome (SJS) is an abnormal immune-response causing extensive exfoliation of the mucocutaneous tissue including conjunctiva. While several factors are associated with the alteration of conjunctival microbiota, the conjunctiva of SJS patients are found to harbor a different microbiota compared to healthy subjects. We investigated the conjunctival microbiota of Korean SJS patients, and identified factors associated with the conjunctival microbiota and its positive culture. Read More

J Dermatol 2022 Jun 19;49(6):629-636. Epub 2022 Apr 19.

Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

The exact efficacy of cyclosporine in the treatment of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) still needs evidence from more clinical data. This study was designed to compare the effectiveness and side-effects of combined use of cyclosporine in the treatment TEN with glucocorticoids (GC)/i.v. Read More

Methods Mol Biol 2022 ;2486:37-54

Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, and Keelung, Taiwan.

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are severe mucocutaneous bullous disorders characterized by widespread skin and mucosal necrosis and detachment, which are most commonly triggered by medications. Despite their rarity, these severe cutaneous adverse drug reactions will result in high mortality and morbidity as well as long-term sequela. The immunopathologic mechanisms is mainly cell-mediated cytotoxic reaction against keratinocytes leading to massive skin necrolysis. Read More

An Bras Dermatol 2022 May-Jun;97(3):402-404. Epub 2022 Apr 2.

Department of Anaesthesiology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.

Crit Care Clin 2022 Apr;38(2):243-269

Department of Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.

There have been major advances in the understanding of severe cutaneous adverse reactions (SCARs). Early recognition and withdrawal of culprit medications can decrease morbidity and mortality significantly. SCARs encompass a variety of entities that present with extensive mucocutaneous involvement and systemic symptoms, often requiring management in an intensive care setting. Read More

JAMA Dermatol 2022 Jun;158(6):607-608

Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

R I Med J (2013) 2022 04 1;105(3):34-36. Epub 2022 Apr 1.

Brown Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Adverse cutaneous reactions associated with the immune checkpoint inhibitor (ICI) pembrolizumab are well documented, yet life-threatening reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) are infrequent.1,2 We present a case of pembrolizumab-induced TEN in a patient with metastatic esophageal adenocarcinoma who was successfully treated with cyclosporine and systemic corticosteroids. Read More

Dermatol Ther 2022 Jun 30;35(6):e15469. Epub 2022 Mar 30.

School of Medicine, University of Zagreb, Zagreb, Croatia.

Ugeskr Laeger 2022 03;184(10)

Afdeling for Hud- og Kønssygdomme, Aalborg Universitetshospital.

The past two years have been dominated by COVID-19, the treatment of this virus, vaccination, and complications due to infection. Not all effects of the virus have yet been described. We present a case report in which the patient suffered from Stevens-Johnson syndrome caused by COVID-19. Read More

Ocul Surf 2022 04 15;24:145-147. Epub 2022 Mar 15.

Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

J Card Surg 2022 Jun 14;37(6):1733-1735. Epub 2022 Mar 14.

Department of Cardiovascular Surgery, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe disorders, characterized by necrosis and epidermal detachment. Most important known acquired etiological factor is medications. Warfarin is one of the most common medications of cardiac valve surgery, which may rarely cause SJS or TEN. Read More

Cochrane Database Syst Rev 2022 03 11;3:CD013130. Epub 2022 Mar 11.

Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada.

Background: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are rare, severe cutaneous adverse reactions usually triggered by medications. In addition to tertiary-level supportive care, various systemic therapies have been used including glucocorticoids, intravenous immunoglobulins (IVIGs), cyclosporin, N-acetylcysteine, thalidomide, infliximab, etanercept, and plasmapheresis. There is an unmet need to understand the efficacy of these interventions. Read More

Clin Exp Dermatol 2022 Jun 1;47(6):1201-1203. Epub 2022 Apr 1.

Departments of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Toxic erythema of chemotherapy is an umbrella term encompassing a range of reactions characterized by symmetric erythematous to dusky patches, which can develop oedema, desquamation and/or purpura. We describe an elderly patient with prostate cancer who developed this complication while receiving docetaxel chemotherapy, presenting with prominent mucosal and periorificial involvement, along with epidermal necrosis, closely mimicking toxic epidermal necrolysis. Read More

Dermatol Ther 2022 May 9;35(5):e15416. Epub 2022 Mar 9.

Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), is a type of delayed hypersensitivity reaction that requires urgent medical intervention. In the COVID-19 era, COVID-19 vaccines are currently being widely administered and mucocutaneous adverse reactions following vaccination have been reported; however, severe cutaneous adverse reactions associated with COVID-19 vaccines including SJS/TEN, are extremely rare. Herein, we describe a case of COVID-19 vaccination induced TEN which developed 1 day after receiving the first dose of Sinopharm COVID-19 vaccine with favorable clinical outcome. Read More