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    6227 results match your criteria Toxic Epidermal Necrolysis

    1 OF 125

    Cutaneous drug reactions to antiepileptic drugs and relation with HLA alleles in the Turkish population.
    Eur Ann Allergy Clin Immunol 2018 Jan;50(1):36-41
    Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey.
    Summary: Background and objective. Many studies have shown associations between HLAB*15:02, HLA-A*31:01 and carbamazepine (CBZ)-induced delayed cutaneous hypersensitivity reactions. The aim of this study is to evaluate a possible association between delayed cutaneous reactions to antiepileptic drugs (AEDs) and certain HLA-A and HLA-B alleles in the Turkish population. Read More

    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

    Toxic Epidermal Necrolysis: A Review of 20 Years of Data.
    J Eur Acad Dermatol Venereol 2018 Jan 5. Epub 2018 Jan 5.
    Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
    Toxic epidermal necrolysis (TEN) is a rare, yet life-threatening immune-mediated mucocutaneous disorder often occurring in the context of a newly administered medication. The cutaneous manifestations are characterized by extensive epidermal detachment, mucosal surface erosion, and multi-organ damage (1-2). This article is protected by copyright. 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

    A Fatal Case of Febrile Ulceronecrotic Mucha-Habermann Disease which Presenting as Toxic Epidermal Necrolysis.
    Indian J Dermatol 2017 Nov-Dec;62(6):675
    Department of Dermatology, Hangzhou Institute of Dermatology and Venereology, The Third People's Hospital of Hangzhou, Hangzhou, China.
    Febrile ulceronecrotic Mucha-Habermann disease (FUMHD), a severe form of pityriasis lichenoides et varioliformis acuta, is an inflammatory dermatosis of unknown etiology manifested by ulcerative and necrotic lesions accompanied by systemic manifestations. The mortality rate of FUMHD is about 15%. It is reported here a case of FUMHD presenting as toxic epidermal necrolysis that resulted in multiple organ failure and death. Read More

    Inpatient Mortality Resulting from Dermatological Disorders at a Tertiary Care Center in Eastern India: A Record-based Observational Study.
    Indian J Dermatol 2017 Nov-Dec;62(6):626-629
    Department of Dermatology, Venereology, and Leprosy, Medical College, Kolkata, West Bengal, India.
    Background: Contrary to popular perception, several dermatological conditions may be associated with lethal outcome in the absence of timely intervention or due to complications.

    Aims: The aim was to estimate the number of deaths and analyze their causes due to skin disorders at a tertiary level inpatient dermatology ward.

    Materials And Methods: We conducted a retrospective, record-based observational study involving 538 patients spanning over 4 years (2013-2016) at our dermatology indoor setup. 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

    High-dose intravenous immunoglobulins for the treatment of dermatological autoimmune diseases.
    J Dtsch Dermatol Ges 2017 Dec;15(12):1211-1226
    Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
    Based on their immunomodulatory properties, high-dose intravenous immunoglobulins (IVIGs) are successfully used in the treatment of various dermatological autoimmune diseases, in particular pemphigus vulgaris and dermatomyositis. In autoimmune bullous diseases, IVIGs can be used in an adjuvant setting (second- or third-line therapy) once combined immunosuppressive regimens have failed. In dermatomyositis, IVIGs may already be employed as an adjuvant second-line therapy after failure of corticosteroid monotherapy. 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

    Intensive Care in a Patient with Toxic Epidermal Necrolysis.
    Case Rep Crit Care 2017 1;2017:3246196. Epub 2017 Nov 1.
    Department of Dermatology and Venerology, HELIOS Klinikum Aue, Gartenstraße 6, 08280 Aue, Germany.
    Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Read More

    Improved drug safety through intensive pharmacovigilance in hospitalized pediatric patients.
    BMC Pharmacol Toxicol 2017 Dec 8;18(1):79. Epub 2017 Dec 8.
    Departamento de Ciencias Médicas y de la Vida. Centro Universitario de la Ciénega, Universidad de Guadalajara, C.P. 47820, Guadalajara, Jalisco, Mexico.
    Background: The aim of this study was to detect and analyze Adverse Drug Reactions (ADRs) through Intensive Pharmacovigilance (IPV) in hospitalized pediatric patients to improve drug safety.

    Methods: A prospective 6-month cross-sectional study was performed in the pediatric service of a regional hospital in Mexico in order to assess hospitalized children from 1 day to 18 years old. The inclusion criteria were: both genders, all hospitalization causes, and at least one prescribed medication (indistinct drug group). Read More

    Case of thymoma-associated cutaneous graft-versus-host disease-like disease successfully improved by narrowband ultraviolet B phototherapy.
    J Dermatol 2017 Dec 7. Epub 2017 Dec 7.
    Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan.
    Thymoma-associated graft-versus-host disease (GVHD)-like disease is a rare paraneoplastic disease seen in patients with thymoma. Here, we describe the first case of thymoma-associated GVHD-like disease localized to the skin that was successfully improved by a combination of systemic corticosteroids and whole-body narrowband ultraviolet (UV)-B phototherapy. The patient had developed toxic epidermal necrolysis-like erosive skin lesions over the whole body. 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

    Toxic Epidermal Necrolysis Spectrum Management at Sunnybrook Health Sciences Centre: Our Multidisciplinary Approach After Review of the Current Evidence.
    J Cutan Med Surg 2017 Dec 1:1203475417746148. Epub 2017 Dec 1.
    1 Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
    Toxic epidermal necrolysis spectrum (TENS) is a rare yet severe adverse drug reaction associated with a high mortality rate. Beyond supportive care, there is still no established therapy for TENS, although recent meta-analyses and UK guideline recommendations have attempted to offer a review of relevant literature on this difficult topic. As most directed treatments lack clear consensual evidence, care centres often resort to establishing their own strategies. 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

    HLAs: Key regulators of T-cell-mediated drug hypersensitivity.
    HLA 2018 Jan;91(1):3-16
    Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, Australia.
    Adverse drug reactions (ADR) can be broadly categorised as either on-target or off-target. On-target ADRs arise as a direct consequence of the pharmacological properties of the drug and are therefore predictable and dose-dependent. On-target ADRs comprise the majority (>80%) of ADRs, relate to the drug's interaction with its known pharmacological target and are a result of a complex interplay of genetic and ecologic factors. Read More

    [From facial pain to toxic epidermal necrolysis: a rare complication of carbamazepine usage].
    Ned Tijdschr Geneeskd 2017 ;161(0):D1895
    Maasstad Ziekenhuis, afd. Intensive Care, Rotterdam.
    Background: Toxic epidermal necrolysis (TEN) is a rare disease that is characterised by epidermal loss, often as a result of medication use - particularly sulfonamides and anti-epileptics. People of South-East Asian descent are at increased risk of developing TEN since they may carry the HLA-B*1502 allele.

    Case Description: A 61-year-old female of Indonesian descent developed TEN due to carbamazepine use, resulting in admission to the intensive care department of a specialised burn centre in the Netherlands. 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

    Treatment of severe drug reactions by hemodialysis.
    Int J Dermatol 2018 Feb 22;57(2):177-182. Epub 2017 Nov 22.
    Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
    Background: Extracorporeal treatments such as hemodialysis and plasma exchange are lifesaving measures in the treatment of drug poisoning. This treatment method generally is not used for severe cutaneous and systemic drug reactions.

    Methods: Here, we describe three cases wherein hemodialysis therapy was instrumental in reversing the adverse drug reaction. 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

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