7,301 results match your criteria Toxic Epidermal Necrolysis


Current Pharmacogenetic Perspective on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

Authors:
Lin Cheng

Front Pharmacol 2021 26;12:588063. Epub 2021 Apr 26.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Adverse drug reactions are a public health issue that draws widespread attention, especially for Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) which have high mortality and lack of efficacious treatment. Though T-cell-mediated HLA-interacted immune response has been extensively studied, our understanding of the mechanism is far from satisfactory. This review summarizes infection (virus, bacterial, and mycoplasma infection), an environmental risk factor, as a trigger for SJS/TEN. Read More

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Emerging Skin Toxicities in Patients with Breast Cancer Treated with New Cyclin-Dependent Kinase 4/6 Inhibitors: A Systematic Review.

Drug Saf 2021 May 6. Epub 2021 May 6.

Department of Dermatology, San Gallicano Dermatological Institute-IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy.

Three cyclin-dependent kinases 4/6, including palbociclib, ribociclib, and abemaciclib, have been approved for the treatment of patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer. The objective of this study was to evaluate the occurrence and clinical spectrum of cutaneous adverse events in patients with breast cancer following therapy with cyclin-dependent kinase 4/6 inhibitors. A systematic literature search was performed in the PubMed, Cochrane, and EMBASE databases up to November 2020 to evaluate studies published from 2015 to 2020. Read More

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Toxic Epidermal Necrolysis-Like Lesions as Cutaneous Manifestation of Acute Methotrexate Toxicity.

Indian Dermatol Online J 2021 Mar-Apr;12(2):340-341. Epub 2020 Sep 28.

Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India.

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September 2020

Factors Predicting the Outcome of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 5-Year Retrospective Study.

Indian Dermatol Online J 2021 Mar-Apr;12(2):258-265. Epub 2021 Mar 2.

Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Clinicodemographic and laboratory parameters predicting the outcome of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) may vary among populations owing to genotypic and environmental variations. There is a scarcity of studies evaluating these parameters in Indian population.

Aims: To analyze clinicodemographic and laboratory parameters predicting disease outcome in patients of SJS/TEN. Read More

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Long-term Physical and Psychological Outcomes of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.

JAMA Dermatol 2021 May 5. Epub 2021 May 5.

Hennepin Healthcare, University of Minnesota Medical School, Minneapolis.

Importance: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is known to cause multiple end-organ complications in its acute phase, but less is known about the long-term association with patients' mental health and quality of life.

Objective: To examine the chronic physical and psychological sequelae affecting patients with SJS/TEN.

Design, Setting, And Participants: A survey study conducted at 11 academic health centers in the US evaluated 121 adults diagnosed with SJS/TEN by inpatient consultive dermatologists between January 1, 2009, and September 30, 2019. Read More

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A Case of Toxic Epidermal Necrolysis Caused by the Use of Trimethoprim Alone.

Cureus 2021 Apr 30;13(4):e14783. Epub 2021 Apr 30.

Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, GBR.

Toxic epidermal necrolysis (TEN) is a rare, acute, severe mucocutaneous reaction commonly presenting following medication use. Thorough history taking and clinical examination are key to early diagnosis and management; skin biopsy provides diagnostic confirmation. We present a 54-year-old man who developed a widespread erythematous rash soon after the use of trimethoprim for an episode of acute prostatitis. Read More

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Childhood vesiculobulous disorder (toxic epidermal necrolysis) in a resource constrained setting.

Acta Biomed 2021 Apr 30;92(S1):e2021085. Epub 2021 Apr 30.

ABIA STATE UNIVERSITY TEACHING HOSPITAL ABA.

We report a case of childhood vesiculobulous disorder of the severity of Toxic Epidermal Necrolysis(TEN) in a 4 year ten month old female child resulting from caregiver prescribed medication. She is one of 4 children of a non consanguineous marriage with no family history of similar adverse drug reactions. She was initially managed in a private hospital before referral to our centre where we observed constraints of funds and crisis of confidence on the part of the parents. Read More

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A Rare Laryngeal Presentation of Stevens-Johnson Syndrome.

Laryngoscope 2021 May 4. Epub 2021 May 4.

Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.

Stevens-Johnson syndrome (SJS) is a rare but severe mucocutaneous epidermolysis commonly triggered by medications. SJS is characterized by mucocutaneous lesions of the trunk, face, and limbs, as well as the oral cavity, gastrointestinal tract, and respiratory tract. Although uncommon, laryngeal involvement in SJS can lead to severe respiratory, phonatory and deglutitive complications. Read More

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Toxic epidermal necrolysis-like presentation of paraneoplastic pemphigus due to underlying thymoma: A clinical conundrum.

J Postgrad Med 2021 Apr-Jun;67(2):119-121

Department of Dermatology, Government Medical College and Hospital, Chandigarh, India.

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Performance of ABCD-10 and SCORTEN Mortality Prediction Models in a Cohort of Patients with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.

J Am Acad Dermatol 2021 Apr 30. Epub 2021 Apr 30.

Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address:

Background: ABCD-10 has recently been proposed as an alternative to the SCORTEN model for predicting in-hospital mortality in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. In contrast to SCORTEN, ABCD-10 incorporates prior dialysis and upweights the impact of cancer.

Objective: To determine ABCD-10's performance compared to SCORTEN in mortality prediction at a large, tertiary burn center. Read More

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Case Report: Wound Closure Acceleration in a Patient With Toxic Epidermal Necrolysis Using a Lyophilised Amniotic Membrane.

Front Bioeng Biotechnol 2021 16;9:649317. Epub 2021 Apr 16.

Department of Burns and Plastic Surgery, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia.

Toxic epidermal necrolysis (TEN) is a rare life-threatening disease that mainly affects the skin and mucous membranes, resulting from a toxic delayed-type hypersensitivity (DTH) reaction (type IV reaction) to the presence of foreign antigens such as drugs. The clinical symptoms are caused by pathophysiological processes leading to massive apoptosis of keratinocytes in the dermo-epidermal junction. This results in the formation of a bulla and subsequent separation of the entire epidermis with the exposure of the dermis. Read More

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Early Diagnosis of Stevens-Johnson Syndrome in the Dental Clinic Setting.

Cureus 2021 Mar 28;13(3):e14160. Epub 2021 Mar 28.

Oral Maxillofacial Surgery and Diagnosis Department, Riyadh Elm University, Riyadh, SAU.

Stevens-Johnson syndrome (SJS) is a life-threatening acute and fatal dermatological disease. It can present with many variations and rapidly worsens in a short period of time. Early diagnosis and management play an important role in stopping SJS from progression. Read More

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Chronic ocular complications in lamotrigine vs. trimethoprim-sulfamethoxazole induced Stevens-Johnson syndrome/toxic epidermal necrolysis.

Ocul Surf 2021 Apr 28;21:16-18. Epub 2021 Apr 28.

Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, United States. Electronic address:

Purpose: The purpose of this study is to compare the severity of chronic ocular complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) induced by lamotrigine (LT) vs. trimethoprim-sulfamethoxazole (TS).

Methods: This retrospective cross-sectional study evaluated all SJS/TEN patients treated within our hospital network from 2008 to 2018. Read More

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Vulvovaginal involvement in pediatric Stevens-Johnson syndrome: A case series.

J Pediatr Adolesc Gynecol 2021 Apr 26. Epub 2021 Apr 26.

Eunice Kennedy Shriver National Institute of Health and Human Development, National Institutes of Health.

Background: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening spectra of mucocutaneous delayed hypersensitivity reactions. Prodromal viral-like symptoms are followed by a characteristic diffuse rash caused by keratinocyte apoptosis and epidermal detachment.

Cases: Three adolescents were admitted with SJS/TEN and vulvovaginal involvement following initiation of Lamictal, Bactrim, and Phenobarbital. Read More

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Mycoplasma induced Steven-Johnson Syndrome/Toxic Epidermal Necrolysis: Case-control analysis of a cohort managed in a specialized center.

J Am Acad Dermatol 2021 Apr 26. Epub 2021 Apr 26.

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

Background: Mycoplasma pneumoniae (MP) infection is associated with extrapulmonary complications such as Stevens-Johnson syndrome (SJS)/Toxic epidermal necrolysis(TEN).

Objective: We evaluated the differences in epidemiology, clinical characteristics, and disease outcomes between drug-induced and mycoplasma related SJS/TEN.

Methods: All patients with SJS/TEN admitted to our center between 2003 and 2016 inclusive were treated under a standardized protocol. Read More

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Carbamazepine Induces Focused T Cell Responses in Resolved Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Cases But Does Not Perturb the Immunopeptidome for T Cell Recognition.

Front Immunol 2021 12;12:653710. Epub 2021 Apr 12.

Infection and Immunity Program, Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.

Antiseizure medications (ASMs) are frequently implicated in T cell-mediated drug hypersensitivity reactions and cause skin tropic pathologies that range in severity from mild rashes to life-threatening systemic syndromes. During the acute stages of the more severe manifestations of these reactions, drug responsive proinflammatory CD8 T cells display classical features of Th1 cytokine production ( IFNγ) and cytolysis ( granzyme B, perforin). These T cells may be found locally at the site of pathology ( blister cells/fluid), as well as systemically ( blood, organs). Read More

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A Case of Generalized Seizure after Toxic Epidermal Necrolysis.

Ann Dermatol 2020 Aug 30;32(4):334-336. Epub 2020 Jun 30.

Department of Dermatology, Chosun University College of Medicine, Gwangju, Korea.

Toxic epidermal necrolysis (TEN) is a severe mucocutaneous adverse reaction characterized by extensive necrosis and epidermal detachment involving more than 30% of the body surface area (BSA). It is commonly triggered by antiepileptics, sulfonamide antibiotics, and non-steroidal anti-inflammatory drugs. A 22-year-old female without any underlying medical history presented with painful multiple erythematous bullae and plaques of varied sizes throughout the body for 1 day. Read More

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as a potential biomarker for carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in Filipino patients.

Pharmacogenomics 2021 Apr 29. Epub 2021 Apr 29.

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

A case-control study was conducted in Filipino patients to determine the association between HLA alleles and carbamazepine-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). A retrospective review of medical records and data collection were performed. A total of 10 carbamazepine-induced SJS/TEN cases and 40 tolerant controls were recruited. Read More

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Assessing Carbamazepine and Oxcarbazepine Associated Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Data Mining the Public Version of the FDA Adverse Event Reporting System.

Int J Clin Pract 2021 Apr 28:e14273. Epub 2021 Apr 28.

Department of Pharmacy, Chongqing University Three Gorges Hospital, Chongqing, 404000, P.R. China.

Aims: Stevens-Johnson syndrome and toxic epidermal necrolysis are viewed as the most severe drug-induced types of cutaneous adverse reactions, with high rates of morbidity and mortality. We aimed to examine carbamazepine- and oxcarbazepine- associated Stevens-Johnson syndrome or toxic epidermal necrolysis, by data mining the US Food and Drug Administration Adverse Event Reporting System (FAERS).

Methods: Reports in FAERs were analyzed, from the first quarter of 2004 to the last quarter of 2019. Read More

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A fatal case of toxic epidermal necrolysis combined with vanishing bile duct syndrome and hemophagocytic lymphohistiocytosis.

J Burn Care Res 2021 Apr 27. Epub 2021 Apr 27.

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

This case report describes a case of fatal Toxic Epidermal Necrolysis complicated by both vanishing bile duct syndrome and hemophagocytic lymphohistiocytosis due to Influenza B infection. Here we highlight the potential for complex morbidity secondary to underlying autoimmune hypersensitivity. Furthermore, the stepwise progression of these pathologies is noted, with the initial epidermal lesions first progressing to cholestatic injury and then subsequently to the hematologic manifestations. Read More

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SJS/TENN: A Mnemonic for Early Clinical Diagnosis of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

Kans J Med 2021 19;14:114-115. Epub 2021 Apr 19.

Department of Internal Medicine, Division of Dermatology, University of Kansas Medical Center, Kansas City, KS.

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End-Stage Respiratory Failure Secondary to Bronchiolitis Obliterans Syndrome Induced by Toxic Epidermal Necrosis, Also Known as Lyell Syndrome: A Case Report.

Transplant Proc 2021 Apr 22. Epub 2021 Apr 22.

Strasbourg Lung Transplant Program, University Hospital, Strasbourg, France; Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious dermatologic diseases. They can be associated with systemic manifestations such as bronchiolitis obliterans syndrome (BOS). SJS/TEN-induced BOS is associated with a poor prognosis, and no guidelines exist regarding its management. Read More

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Safety of administering cefazolin versus other antibiotics in penicillin-allergic patients for surgical prophylaxis at a major Canadian teaching hospital.

Surgery 2021 Apr 21. Epub 2021 Apr 21.

ASPIRES (Antimicrobial Stewardship Programme), Medicine Quality and Safety, Vancouver Coastal Health, Vancouver, BC, Canada; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada; Pharmaceutical Sciences, Vancouver General Hospital, Vancouver Coastal Health, Vancouver, BC, Canada; Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada. Electronic address:

Background: Cefazolin surgical prophylaxis is associated with better patient outcomes; however, its use in penicillin-allergic patients is controversial. We evaluated the safety of cefazolin as surgical prophylaxis in penicillin-allergic patients, including those with anaphylaxis histories.

Methods: We conducted a pre and postintervention quality improvement evaluation of an institution-wide policy change at a tertiary-care hospital, before (October 2017-January 2018), during (February 2018-September 2018), and after (October 2018-October 2019) transition to routine cefazolin prophylaxis for penicillin-allergic patients, including those with anaphylaxis histories but excluding severe delayed reactions (eg, Stevens-Johnson syndrome). Read More

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Sutureless dehydrated amniotic membrane for persistent epithelial defects.

Eur J Ophthalmol 2021 Apr 22:11206721211011354. Epub 2021 Apr 22.

Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.

Purpose: To report outcomes of a sutureless dehydrated amniotic membrane for persistent epithelial defects (PED).

Methods: This retrospective study included consecutive patients with a PED (⩾14 days) treated with a sutureless dehydrated amniotic membrane and bandage contact lens (BCL). Included were patients with an epithelial defect that did not respond to treatment with a BCL. Read More

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Amniotic Membrane-Covered Conformer and Fibrin Glue for Toxic Epidermal Necrolysis.

Cornea 2021 Apr;40(4):525-528

*Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Australia; †University of Queensland, Herston, Australia; ‡Discipline of Paediatrics and Child Health, University of Queensland, Queensland Children's Hospital, Brisbane, Australia; and §City Eye Centre, Brisbane, Australia.

Purpose: Stevens-Johnson syndrome and its more severe form, toxic epidermal necrolysis, are immunologic disorders that cause widespread blistering of the skin and mucous membranes. Its incidence is higher in children and can lead to long-term disabling ocular surface complications that can be averted with amniotic membrane transplantation early in the disease. To introduce an amniotic membrane treatment technique that is time efficient and minimally invasive but still allows for extensive coverage of the ocular mucosal surfaces to prevent and lessen the severity of the complications from ocular surface sequelae. Read More

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A Cautionary Tale of Criteria Based on Anecdotal Evidence with Etanercept in Toxic Epidermal Necrolysis.

J Burn Care Res 2021 Apr 21. Epub 2021 Apr 21.

Department of Dermatology, Wayne State University, Detroit, MI USA.

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Pholcodine-induced Stevens-Johnson syndrome in a patient with COVID-19.

Postgrad Med J 2021 Apr 20. Epub 2021 Apr 20.

Department of Dermatology and Venereology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.

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Immune checkpoint inhibitor-related Stevens-Johnson syndrome/toxic epidermal necrolysis-like reactions.

J Am Acad Dermatol 2021 Apr 18. Epub 2021 Apr 18.

Division of Dermatology, National Skin Centre, Singapore.

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Response to: "Immune checkpoint inhibitor-related Stevens-Johnson syndrome/toxic epidermal necrolysis-like reactions".

J Am Acad Dermatol 2021 Apr 18. Epub 2021 Apr 18.

Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. Electronic address:

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Mycoplasma pneumoniae-induced rash and mucositis: A new entity.

Indian J Dermatol Venereol Leprol 2021 Mar 12:1-5. Epub 2021 Mar 12.

Department Dermatology Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia.

Mycoplasma pneumoniae is a well-known cause of community-acquired pneumonia, mostly associated with dermatological manifestations especially with mucosal involvement and targetoid cutaneous lesions. For many years, it was considered among the spectrum of erythema multiforme. Recently, some authors have recommended the creation of a new syndrome called "mycoplasma-induced rash and mucositis. Read More

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