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    5849 results match your criteria Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

    1 OF 117

    Vitreoretinal Complications and Outcomes in 92 Eyes Undergoing Surgery for Modified Osteo-Odonto-Keratoprosthesis: A 10-Year Review.
    Ophthalmology 2018 Jan 13. Epub 2018 Jan 13.
    CJ Shah Cornea Services and Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Chennai, India.
    Purpose: To analyze vitreoretinal (VR) complications and treatment outcomes in eyes undergoing modified osteo-odonto-keratoprosthesis (OOKP) surgery.

    Design: Retrospective case series.

    Participants: All patients who underwent modified OOKP (mOOKP) surgery at a tertiary eye-care center from March 2003 to February 2013 were included. Read More

    Toxic epidermal necrolysis: a paradigm of critical illness.
    Rev Bras Ter Intensiva 2017 Oct-Dec;29(4):499-508
    Instituto de Investigación Sanitaria del Hospital Universitario de Getafe - Madrid, Spain.
    Toxic epidermal necrolysis is an adverse immunological skin reaction secondary in most cases to the administration of a drug. Toxic epidermal necrolysis, Stevens-Johnson syndrome, and multiform exudative erythema are part of the same disease spectrum. The mortality rate from toxic epidermal necrolysis is approximately 30%. Read More

    First Case of Stevens-Johnson Syndrome After Rabies Vaccination.
    Br J Clin Pharmacol 2018 Jan 15. Epub 2018 Jan 15.
    Department of Pharmacy, Xi'an Central Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
    We describe the first case of Stevens-Johnson syndrome (SJS) occurring 8 days after the first dose of a 3-dose rabies vaccination series. She had no history of vaccine-related rash or other adverse drug reactions, nor had she received any other drug therapy. The temporal relationship between the development of SJS and the vaccination suggests that the rabies vaccination probably was the causal agent. Read More

    HLA Association with Drug-Induced Adverse Reactions.
    J Immunol Res 2017 23;2017:3186328. Epub 2017 Nov 23.
    Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.
    Adverse drug reactions (ADRs) remain a common and major problem in healthcare. Severe cutaneous adverse drug reactions (SCARs), such as Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) with mortality rate ranges from 10% to more than 30%, can be life threatening. A number of recent studies demonstrated that ADRs possess strong genetic predisposition. Read More

    Maternal Serum Eye Drops in the Management of Pediatric Persistent Corneal Epithelial Defects: A Case Series.
    Cornea 2018 Jan 10. Epub 2018 Jan 10.
    Department of Ophthalmology, University of Colorado, Aurora, CO.
    Purpose: We report our experience with the use of maternally derived serum eye drops as adjunctive treatment in the management of pediatric persistent corneal epithelial defects.

    Methods: Five eyes of 4 patients were identified in a retrospective review of pediatric patients with persistent corneal epithelial defects who received maternal serum drops. Diagnoses associated with the defects comprised pontine tegmental cap dysplasia with bilateral cranial nerve V1, V2, V3, and VII palsies; pontine tegmental cap dysplasia with left cranial nerve V1, VII, and VIII palsies; traumatic left cranial nerve II, V1, V2, and VI palsies due to a basilar skull fracture; and Stevens-Johnson syndrome with ocular involvement. Read More

    Drug-induced Liver Injury is Frequently Associated with Severe Cutaneous Adverse Drug Reactions: Experience from Two Australian Tertiary Hospitals.
    Intern Med J 2018 Jan 8. Epub 2018 Jan 8.
    Alfred Health, Victoria, Melbourne, Australia.
    Background: Drug-induced liver injury can be associated with certain cutaneous adverse drug reactions.

    Aims: We aim to demonstrate the prevalence of drug-induced liver injury in patients with cutaneous adverse drug reactions. Severity and patterns of liver injury, risk factors, causal medications and outcomes are also examined. Read More

    Incidence, outcomes, and resource use in children with Stevens-Johnson syndrome and toxic epidermal necrolysis.
    Pediatr Dermatol 2018 Jan 9. Epub 2018 Jan 9.
    Department of Pediatric and Adolescent Medicine, Children's Hospital, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA.
    Background/objectives: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening cutaneous reactions, typically to drugs or infection. The incidence and outcomes of these conditions in children are unknown. The objective of this study was to report the overall burden of Stevens-Johnson syndrome and toxic epidermal necrolysis in children in the United States. Read More

    SJS/TEN 2017: Building Multidisciplinary Networks to Drive Science and Translation.
    J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):38-69
    Vanderbilt University Medical Center, Nashville, Tenn; Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia. Electronic address:
    Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a life-threatening, immunologically mediated, and usually drug-induced disease with a high burden to individuals, their families, and society with an annual incidence of 1 to 5 per 1,000,000. To effect significant reduction in short- and long-term morbidity and mortality, and advance clinical care and research, coordination of multiple medical, surgical, behavioral, and basic scientific disciplines is required. On March 2, 2017, an investigator-driven meeting was held immediately before the American Academy of Dermatology Annual meeting for the central purpose of assembling, for the first time in the United States, clinicians and scientists from multiple disciplines involved in SJS/TEN clinical care and basic science research. Read More

    Influenza B virus infection and Stevens-Johnson syndrome.
    Pediatr Dermatol 2017 Dec 28. Epub 2017 Dec 28.
    Department of Dermatology, Columbia University Medical Center, New York, NY, USA.
    A 2-year-old boy with influenza B infection and rapidly worsening targetoid skin lesions with mucosal involvement was diagnosed with Stevens-Johnson syndrome (SJS) and treated with oseltamivir and intravenous immunoglobulin, with resolution of illness. Subsequent quadrivalent inactivated influenza vaccine was well tolerated. This case highlights the rarity of SJS in the setting of influenza B infection and addresses the safety of administering subsequent influenza vaccines to such individuals. Read More

    [Histopathology of cutaneous drug reactions].
    Ann Pathol 2017 Dec 23. Epub 2017 Dec 23.
    Département de pathologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. Electronic address:
    There are many different types of cutaneous adverse reactions. The most classical reactions are driven by T lymphocytes that specifically react towards a drug, with an individual genetic susceptibility linked to certain type I major histocompatibility complex alleles. These reactions are characterized by a wide variety of clinical and histopathological presentations, and a wide range of severity. Read More

    Association of CYP2C9*3 with phenytoin-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review and meta-analysis.
    J Clin Pharm Ther 2017 Dec 23. Epub 2017 Dec 23.
    Department of Allergy, Chongqing General Hospital, Chongqing, China.
    What Is Known And Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions that can be induced by phenytoin (PHT). CYP2C9*3 is the key enzyme in PHT metabolism. The aim of this meta-analysis was to evaluate the association between CYP2C9*3 and PHT-induced SJS/TEN. Read More

    Antibiotic drug use and the risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis A Population-Based Case-Control Study.
    J Invest Dermatol 2017 Dec 19. Epub 2017 Dec 19.
    Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life-threatening mucocutaneous adverse drug reactions. Sulphonamide antibiotics are commonly accepted as one of the primary causes of SJS/TEN. This notion is based on results from two hospital-based case-control studies that identified the combined antibiotic cotrimoxazole (sulfamethoxazole and trimethoprim) as the cause of several SJS/TEN cases. Read More

    Effectiveness of photodynamic therapy with verteporfin combined with intrastromal bevacizumab for corneal neovascularization in Stevens-Johnson syndrome.
    Int Ophthalmol 2017 Dec 18. Epub 2017 Dec 18.
    Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 501-757, South Korea.
    Purpose: To investigate the effectiveness of combined photodynamic therapy with verteporfin and intrastromal injection of bevacizumab for the treatment of corneal neovascularization in patients with Stevens-Johnson syndrome (SJS).

    Methods: Eight eyes of eight patients with SJS having corneal neovascularization who were refractory to 1% prednisolone instillation received photodynamic therapy with verteporfin (6 mg/m2) combined with intrastromal bevacizumab injection (2.5 mg/0. Read More

    [Analysis of Advanced or Postoperative Recurrent Non-small Lung Cancer Cases Treated with Nivolumab].
    J UOEH 2017 ;39(4):291-297
    Department of Surgery, Onga Nakama Medical Association Onga Hospital, Japan.
    Recent developments in cancer immunotherapy are remarkable. Many reports have described the clinical effects of immune checkpoint inhibitors (ICIs), supporting their utility as a promising therapy that will achieve prominent effects even in patients resistant to cytotoxic anticancer drugs or gene-targeting therapy. ICIs may also prolong overall survival. Read More

    [What's new in dermatological treatment?]
    Ann Dermatol Venereol 2017 Dec;144 Suppl 4:IVS47-IVS53
    Service de dermatologie, hôpital Robert-Debré, Reims, France. Electronic address:
    On a therapeutic point of view, 2017 in dermatology could be summarized in one disease, one pathway and in one number : atopic dermatitis, JAK inhibitors and 23. 2017 will be the year of the first registration of a biologic treatment in atopic dermatitis, dupilumab, with numerous other drugs currently in development. JAK inhibitors show promising results in several difficult-to-treat conditions, such as alopecia areata, vitiligo or atopic dermatitis, but still warrant confirmation in upcoming controlled trials. Read More

    Specific association of the rs6500265 and rs9933632 single-nucleotide polymorphisms in Japanese patients with antipyretic analgesic-related Stevens-Johnson syndrome and toxic epidermal necrolysis with severe ocular involvements.
    Pharmacogenet Genomics 2017 Dec 12. Epub 2017 Dec 12.
    Division of Medicinal Safety Science, National Institute of Health Sciences, Tokyo.
    A recent study using the microarray for single-nucleotide polymorphisms (SNPs) genotyping specifically designed for the Japanese population in combination with genome-wide imputation showed the association of several SNPs with cold medicine-related Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with severe ocular complications. However, it remains to be determined whether these polymorphisms are associated with the onset of antipyretic analgesic (AA)-related SJS/TEN, the progression of severe ocular involvements (SOIs), or both AA-related SJS/TEN and SOI phenotypes. To gain a better understanding of the features of these genetic markers, we compared the allele and carrier frequencies of these SNPs among our original SJS/TEN patient groups: (a) AA-related SJS/TEN with SOIs, (b) AA-related SJS/TEN without SOIs, and (c) AA-unrelated SJS/TEN with SOIs. Read More

    Association of HLA-A and HLA-B Alleles with Lamotrigine-Induced Cutaneous Adverse Drug Reactions in the Thai Population.
    Front Pharmacol 2017 29;8:879. Epub 2017 Nov 29.
    Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
    Background: Lamotrigine (LTG) is commonly used for treatment of epilepsy and bipolar disorder. It is one of the common cause of cutaneous adverse drug reactions (CADR). Clinical symptoms of LTG-induced CADR range from maculopapular exanthema (MPE) to severe cutaneous adverse reactions (SCAR). Read More

    Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions.
    J Immunol Res 2017 31;2017:6928363. Epub 2017 Oct 31.
    Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
    Diagnosis of severe cutaneous adverse drug reactions should involve immunohistopathological examination, which gives insight into the pathomechanisms of these disorders. The characteristic histological findings of erythema multiforme (EM), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) provide conclusive evidence demonstrating that SJS/TEN can be distinguished from EM. Established SJS/TEN shows full-thickness, extensive keratinocyte necrosis that develops into subepidermal bullae. Read More

    Cataract surgery in ocular surface diseases: clinical challenges and outcomes.
    Curr Opin Ophthalmol 2018 Jan;29(1):81-87
    Cornea service, Nethradhama Eye Hospital, Bangalore, Karnataka, India.
    Purpose Of Review: Cataracts are a significant cause of blindness and visual impairment worldwide. With the recent advances in cataract surgery techniques, outcomes have improved significantly in uncomplicated cases. This article discusses the challenges and outcomes of cataract surgery in complex cases targeting eyes with ocular surface diseases like Stevens-Johnson syndrome, ocular cicatricial pemphigoid, Mooren's ulcer, vernal keratoconjunctivitis and limbal stem cell deficiency. Read More

    Drug-induced hypersensitivity syndrome caused by valproic acid as a monotherapy for epilepsy: First case report in Asian population.
    Epilepsy Behav Case Rep 2017 20;8:108-110. Epub 2017 Jun 20.
    Department of Neurology - Biomagnetism, University Hospital Erlangen, Germany.
    Valproic acid (VPA) is a broad-spectrum antiseizure drug used for a variety of clinical conditions, such as epilepsy and mood disorders. Drug-induced hypersensitivity syndrome (DRESS) accompanied by hyponatremia, thrombocytopenia, hypoalbuminemia and elevated aminotransferase has never been reported as an adverse effect of VPA monotherapy during titration for epilepsy in Asian population. Hereby, we present the case of a 73-year-old Chinese male who suffered from DRESS and other complications two weeks after initiating VPA treatment for epilepsy. Read More

    Functional SNP allele discovery (fSNPd): an approach to find highly penetrant, environmental-triggered genotypes underlying complex human phenotypes.
    BMC Genomics 2017 Dec 4;18(1):944. Epub 2017 Dec 4.
    Cambridge Institute for Medical Research, Wellcome Trust and MRC Building, Addenbrooke's Hospital campus, Cambridge, UK.
    Background: Significant human diseases/phenotypes exist which require both an environmental trigger event and a genetic predisposition before the disease/phenotype emerges, e.g. Carbamazepine with the rare SNP allele of rs3909184 causing Stevens Johnson syndrome, and aminoglycosides with rs267606617 causing sensory neural deafness. Read More

    The minor allele HCP5 rs3099844 A, PSORS1C1 rs3131003 G are associated with allopurinol-induced severe cutaneous adverse reactions in Han Chinese: a multicentre retrospective case-control clinical study.
    Br J Dermatol 2017 Nov 28. Epub 2017 Nov 28.
    Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, P. R. China.
    allopurinol-induced severe cutaneous adverse reactions (SCARs), which includes drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), are life threatening conditions and occur almost exclusively in HLA-B*5801 positive individuals in Han Chinese1-4 . This article is protected by copyright. All rights reserved. Read More

    Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.
    Clin Rev Allergy Immunol 2017 Nov 29. Epub 2017 Nov 29.
    Unité d'allergologie, Service d'immunologie et d'allergologie, Hôpitaux Universitaires de Genève HUG, Genève, Switzerland.
    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered a delayed-type hypersensitivity reaction to drugs. They represent true medical emergencies and an early recognition and appropriate management is decisive for the survival. SJS/TEN manifest with an "influenza-like" prodromal phase (malaise, fever), followed by painful cutaneous and mucous membrane (ocular, oral, and genital) lesions, and other systemic symptoms. Read More

    Severe cutaneous adverse drug reactions of Chinese inpatients: a meta-analysis.
    An Bras Dermatol 2017 May-Jun;92(3):345-349
    Department of Dermatology, Third Xiangya Hospital, Central South University - Changsha, China.
    Background: The rate of severe cutaneous adverse drug reactions is low, and these reactions can result in death or disability. An evidence-based epidemiological study of severe cutaneous adverse drug reactions in China has not been reported.

    Objective: The aim of this study was to analyze epidemiology and characteristics of severe cutaneous adverse drug reactions of Chinese inpatients during the recent 15 years with meta-analysis. Read More

    Cutaneous Adverse Drug Reactions to Lamotrigine and Human Leukocyte Antigen Typing in North Indian Patients: A Case Series.
    Ann Indian Acad Neurol 2017 Oct-Dec;20(4):408-410
    Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
    Cutaneous adverse drug reaction (cADR) has limited epidemiological data in India. The older antiepileptic drugs, i.e. Read More

    Atypical Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6 in Denmark: A Diagnostic Mimicker.
    Acta Derm Venereol 2017 Nov 28. Epub 2017 Nov 28.
    Department of Dermatology and Allergy Centre, Odense University Hospital, DK-5000 Odense C, Denmark.
    Since 2008, outbreaks of atypical hand, foot, and mouth disease (HFMD) in children and adults have been reported worldwide. The majority of these outbreaks are caused by a new lineage of Coxsackie virus A6 (CV-A6) presenting a more severe clinical phenotype than the classical childhood HFMD caused by CV-A16. Between June 2014 and January 2016, 23 cases of atypical HFMD disease presented at a Dermatology Department at a regional University Hospital in Denmark. Read More

    Discontinuation of Efavirenz in Paediatric Patients: Why do Children Switch?
    Clin Drug Investig 2017 Nov 27. Epub 2017 Nov 27.
    The Family Clinic, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London, UK.
    Background: Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is used globally as first-line antiretroviral therapy (ART) in combination with a dual nucleoside backbone in adults and children from 3 years of age. Up to 40% of adults taking efavirenz report central nervous system (CNS) adverse effects, and the rates of discontinuation of efavirenz-based treatment are higher than other first-line regimens. Data on efavirenz discontinuation are more limited for children and adolescents. Read More

    Cost-effectiveness analysis of HLA-B*58: 01 genetic testing before initiation of allopurinol therapy to prevent allopurinol-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in a Malaysian population.
    Pharmacogenet Genomics 2018 02;28(2):56-67
    School of Pharmacy.
    Objective: Studies found a strong association between allopurinol-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and the HLA-B*58:01 allele. HLA-B*58:01 screening-guided therapy may mitigate the risk of allopurinol-induced SJS/TEN. This study aimed to evaluate the cost-effectiveness of HLA-B*58:01 screening before allopurinol therapy initiation compared with the current practice of no screening for Malaysian patients with chronic gout in whom a hypouricemic agent is indicated. Read More

    [Ocular involvement in Stevens-Johnson syndrome: treatment with amniotic membrane transplantation in the acute phase].
    Ned Tijdschr Geneeskd 2017 ;161(0):D1739
    Universitair Medisch Centrum Groningen-Rijksuniversiteit Groningen, Groningen.
    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are both part of a spectrum of serious mucocutaneous disorders, most often caused by drugs, with a high morbidity and mortality. In the acute stage, serious skin and mucocutaneous lesions with painful blistering, erosions and systemic involvement present the main focus of attention. The severity of skin manifestations in the acute stage, however, does not necessarily correlate with that of the mucosal lesions. Read More

    Stevens-Johnson syndrome and toxic epidermal necrolysis: epidemiological and clinical outcomes analysis in public hospitals.
    An Bras Dermatol 2017 Sep-Oct;92(5):661-667
    Stricto Sensu Postgraduate Program In Health Sciences of Fundação de Ensino e Pesquisa em Ciências da Saúde (FEPECS) - Brasília (DF), Brazil.
    Background: Adverse drug reactions are harmful and involuntary responses to drugs that occur at doses normally used for a given condition. Among them are Stevens-Johnson syndrome and toxic epidermal necrolysis, both rare and potentially fatal conditions.

    Objectives: To analyze the epidemiological and clinical characteristics related to patients diagnosed with Stevens-Johnson syndrome and toxic epidermal necrolysis in public hospitals in the Federal District - Brazil. Read More

    Association of Human Leukocyte Antigen Class 1 genes with Stevens Johnson Syndrome with severe ocular complications in an Indian population.
    Sci Rep 2017 Nov 21;7(1):15960. Epub 2017 Nov 21.
    Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
    Stevens Johnson syndrome (SJS) is part of a spectrum of adverse drug reactions resulting in the destruction of skin, mucous membranes, and the ocular surface. A similar, more severe form of the disorder included in this spectrum is toxic epidermal necrolysis (TEN). Approximately 35% of patients suffer chronic sequelae such as vascularization, corneal scarring, conjunctival inversion to the cornea, keratinization, symblepharon, scarring of the palpebral conjunctiva, trichiasis, and severe dry eye. Read More

    Severe Stevens-Johnson syndrome/toxic epidermal necrolysis overlap syndrome-beyond skin involvement.
    Pediatr Dermatol 2017 Nov 21. Epub 2017 Nov 21.
    Centro Hospitalar de Lisboa Central-EPE, Hospital Dona Estefânia, Lisbon, Portugal.
    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious dermatologic diseases with many potential multisystem complications. We describe the case of an 8-year-old girl who developed severe SJS/TEN overlap syndrome (25% of her body surface area was affected) complicated by pancreatitis and bronchiolitis obliterans. These rare complications emphasize the need for careful, intensive monitoring of possible complications and an interdisciplinary team approach to provide optimal treatment and follow-up. Read More

    The safety of live attenuated influenza vaccine in children and adolescents 2 through 17 years of age: A Vaccine Safety Datalink study.
    Pharmacoepidemiol Drug Saf 2018 Jan 17;27(1):59-68. Epub 2017 Nov 17.
    Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
    Purpose: To evaluate the safety of live attenuated influenza vaccine (LAIV) in children 2 through 17 years of age.

    Methods: The study was conducted in 6 large integrated health care organizations participating in the Vaccine Safety Datalink (VSD). Trivalent LAIV safety was assessed in children who received LAIV between September 1, 2003 and March 31, 2013. Read More

    Research Directions in Genetic Predispositions to Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis.
    Clin Pharmacol Ther 2017 Nov 6. Epub 2017 Nov 6.
    Department of Medicine (Dermatology and Clinical Pharmacology and Toxicology), University of Toronto, Toronto, Canada.
    Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is one of the most devastating of adverse drug reactions (ADRs) and was, until recently, essentially unpredictable. With the discovery of several risk alleles for drug-induced SJS/TEN and the demonstration of effectiveness of screening in reducing incidence, the stage is set for implementation of preventive strategies in populations at risk. Yet much remains to be learned about this potentially fatal complication of commonly used drugs. Read More

    The Combined Utility of Ex vivo IFN-γ Release Enzyme-Linked ImmunoSpot Assay and In vivo Skin Testing in Patients With Antibiotic-Associated Severe Cutaneous Adverse Reactions.
    J Allergy Clin Immunol Pract 2017 Oct 31. Epub 2017 Oct 31.
    Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia; Departments of Medicine & Pharmacology, Vanderbilt University, Nashville, Tenn.
    Background: For severe cutaneous adverse reactions (SCARs) associated with multiple antibiotics dosed concurrently, clinical causality is challenging and diagnostic approaches are limited, leading to constricted future antibiotic choices.

    Objective: To examine the combined utility of in vivo and ex vivo diagnostic approaches at assigning drug causality in a cohort of patients with antibiotic-associated (AA)-SCARs.

    Methods: Patients with AA-SCARs were prospectively recruited between April 2015 and February 2017. Read More

    Prophylactic effect of trimethoprim-sulfamethoxazole for pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged high-dose glucocorticoids.
    Ann Rheum Dis 2017 Nov 1. Epub 2017 Nov 1.
    Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
    Objectives: To investigate the efficacy and safety of trimethoprim/sulfamethoxazole (TMP-SMX) as primary prophylaxis for pneumocystis pneumonia (PCP) in patients with rheumatic diseases receiving high-dose steroids.

    Methods: The study included 1522 treatment episodes with prolonged (≥4 weeks) high-dose (≥30 mg/day prednisone) steroids in 1092 patients over a 12-year period. Of these, 262 treatment episodes involved TMP-SMX (prophylaxis group) while other episodes involved no prophylaxis (control group). Read More

    Stevens Johnson Syndrome versus Jarisch Herxheimer Reaction in an HIV Positive Patient with Secondary Syphilis.
    Recent Pat Inflamm Allergy Drug Discov 2017 ;11(2):125-128
    Gregorio Maranon Health Research Institute, Madrid. Spain.
    Background: HIV positive patients can suffer many complications due to infectious diseases. A sever drug reaction to some of the drugs involved in the treatment can overlap the symptoms of the infections, making the diagnosis very difficult. We present the case of a 28-year-old-man, HIV positive, with secondary syphilis, who developed a Stevens Johnson Syndrome (SJS) caused by one of the many drugs he received. Read More

    The association of HLA B*15:02 allele and Stevens-Johnson syndrome/toxic epidermal necrolysis induced by aromatic anticonvulsant drugs in a South Indian population.
    Int J Dermatol 2018 Jan 26;57(1):70-73. Epub 2017 Oct 26.
    Department of Dermatology, Government Medical College, Thrissur, Kerala, India.
    Background: The presence of HLA-B*15:02 allele is considered a risk factor for development of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in patients taking aromatic anticonvulsant drugs like carbamazepine and phenytoin. The genetic association is ethnicity specific. Testing for HLA-B*15:02 allele is suggested as a prerequisite before starting carbamazepine in certain ethnic groups. Read More

    Life-Threatening Atypical Case of Acute Generalized Exanthematous Pustulosis.
    Int Arch Allergy Immunol 2017 25;174(2):108-111. Epub 2017 Oct 25.
    Departmens of Dermatology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
    Antibiotics are known to cause severe cutaneous adverse reactions, such as the rare acute generalized exanthematous pustulosis (AGEP). Unlike Stevens-Johnson syndrome or toxic epidermal necrolysis, AGEP is rarely life-threatening. Systemic involvement is not typical, and if present usually coincides with a mild elevation of the hepatic enzymes and a decrease in renal function. Read More

    [The major SCAR syndromes].
    Rev Med Liege 2017 Oct;72(10):444-447
    Service de Dermatopathologie et Consultant Service de Dermatologie, CHU de Liège, site du Sart Tilman, Liège, Belgique.
    Some drug eruptions are frequent and follow an indolent course, while others prove to be life-threatening. By contrast, SCAR syndromes are serious skin drug reactions that are rare but their vital prognosis is affected. The three distinct entities of importance are the former Lyell's syndrome, now identified as SJS-TEN syndrome (Stevens-Johnson syndrome/toxic epidermal necrolysis), the DRESS syndrome (drug reaction with eosinophilia and systemic symptoms), and the AGEP syndrome (acute generalized exanthematous pustulosis). Read More

    Association of the HLA-B alleles with carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in the Javanese and Sundanese population of Indonesia: the important role of the HLA-B75 serotype.
    Pharmacogenomics 2017 Dec 20;18(18):1643-1648. Epub 2017 Oct 20.
    College of Pharmacy, University of Florida, Gainesville, FL 32603, USA.
    Carbamazepine (CBZ) is a common cause of life-threatening cutaneous adverse drug reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Previous studies have reported a strong association between the HLA genotype and CBZ-induced SJS/TEN. We investigated the association between the HLA genotype and CBZ-induced SJS/TEN in Javanese and Sundanese patients in Indonesia. Read More

    Severe Physical Complications among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.
    Drug Saf 2017 Oct 19. Epub 2017 Oct 19.
    Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Suite MI-700, Toronto, ON, M4N 3M5, Canada.
    Introduction: Few studies have reported the physical complications among Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) survivors.

    Objective: The aim of this study was to comprehensively characterize the physical complications among SJS/TEN survivors and to learn about patients' perspectives of surviving SJS/TEN.

    Methods: SJS/TEN survivors older than 18 years of age were assessed by different methods: a medical interview; a questionnaire assessing patients' perspectives; thorough skin, oral mucous membrane, and ophthalmic examinations; and a retrospective assessment of medical records. Read More

    Safety of resuming anti-PD-1 in patients with immune-related adverse events (irAEs) during combined anti-CTLA-4 and anti-PD1 in metastatic melanoma.
    Ann Oncol 2017 Oct 11. Epub 2017 Oct 11.
    Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
    Background: Combined CTLA-4 and PD-1 blockade induces high rates of immune-related adverse events (irAEs). The safety of resuming anti-PD-1 in patients who discontinue combination therapy due to irAEs is not known.

    Patients And Methods: We assessed patients who experienced clinically significant irAEs from combined CTLA-4 and PD-1 blockade leading to treatment discontinuation at four academic centers. Read More

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