Stevens-Johnson syndrome and toxic epidermal necrolysis: follow-up of pulmonary function after remission

Duong, Tu-Anh; Prost, Nicolas de; Ingen‐Housz‐Oro, Saskia; Carrié, Alain; Zérah, Françoise; Valeyrie‐Allanore, Laurence; Bagot, M.; Chosidow, Olivier; Roujeau, Jean‐Claude; Wolkenstein, Pierre; Maître, Bernard

doi:10.1111/bjd.13505

Cited by 26 publications

(23 citation statements)

References 20 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the contrary, the distribution of IVIG application among SJS/TEN patients requiring mechanical ventilation or not was described[59]. Likewise, another study reported the distribution of cyclosporine treatment among delayed pulmonary dysfunction patients with and without diffusion impairment[60]. A Japanese patient with SJS developed progressive dyspnea attacks after administration of betamethasone over one month.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis

Ye¹,

Zhang²,

Zhu³

2016

PLoS ONE

View full text Add to dashboard Cite

BackgroundIntravenous immunoglobulin (IVIG) treatment is commonly used to treat Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with controversial therapeutic effect.MethodsWe conducted a comprehensive meta-analysis through combining the published eligible studies to evaluate the effectiveness of IVIG on SJS and TEN treatment.ResultsA total of 26 studies were selected from public available databases. The combination of IVIG and corticosteroid markedly reduced the recovery time (by 1.63 days, 95% CI: 0.83–2.43, P < 0.001), compared with solo corticosteroid group. The favorable effects were greater in Asian (2.19, 95% CI: 1.41–2.97, P < 0.001), TEN (2.56, 95% CI: 0.35–4.77, P = 0.023) and high-dose IVIG treated individuals (1.78, 95% CI: 0.42–3.14, P = 0.010). The hospitalization length reduced by 3.19 days (95% CI: 0.08–6.30, P = 0.045), though the outcome was proven to be unstable. We found heterogeneities, which sources were probably regional factors. Besides, IVIG was inclined to decrease SJS/TEN mortality (SMR: 0.84, 95% CI: 0.66–1.08, P = 0.178). This impact was possibly more profound when patients were treated with high dose IVIG (SMR: 0.74, 95% CI: 0.50–1.08, P = 0.116), or when patients were diagnosed as TEN (SMR: 0.68, 95% CI: 0.45–1.01, P = 0.058).ConclusionsOur current meta-analysis suggests that IVIG combined with corticosteroid could reduce recovery time for SJS and TEN. This effect is greater among Asian patients. Whereas, its impact on reducing mortality is not significant.

show abstract

Section: Discussionmentioning

confidence: 99%

The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis

Ye¹,

Zhang²,

Zhu³

2016

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…severe pain, organ involvement, long hospital stay), long‐term morbidity (e.g. ophthalmological or pulmonary sequelae, post‐traumatic stress disorder), associated healthcare costs and mortality rate …”

mentioning

confidence: 99%

Incidence of and mortality from epidermal necrolysis (Stevens–Johnson syndrome/toxic epidermal necrolysis) in France during 2003–16: a four‐source capture–recapture estimate

et al. 2019

Self Cite

View full text Add to dashboard Cite

Summary Background Because of its rarity, the exact incidence of and mortality from epidermal necrolysis (Stevens–Johnson syndrome/toxic epidermal necrolysis) is difficult to establish and closely depends on the size and type of the data source. Objectives To estimate the incidence of and mortality due to epidermal necrolysis in France over a 14‐year period. Methods Data from four national databases were analysed. A capture–recapture analysis was performed. Results A total of 2635 incident cases of epidermal necrolysis were recorded in at least one of the four databases during the study period [males: 47·9%; median age: 52 (interquartile range 25–72) years]. On capture–recapture analysis, the estimated total number of cases was 5686, for an overall estimated annual incidence of 6·5 (95% confidence interval 4·1–8·9) cases per million inhabitants. The estimated annual incidence rates were 4·1 (0·3–7·9) cases per million inhabitants < 20 years of age, 3·9 (1·5–6·3) cases per million inhabitants aged 20–64 years and 13·7 (5·4–22·0) cases per million inhabitants ≥ 65 years of age. The estimated overall annual mortality rate from epidermal necrolysis was 0·9 (0·1–1·8) case per million inhabitants. It was 0·6 (0·1–1·5) case per million inhabitants aged 20–64 years and 2·8 (0·9–6·6) cases per million inhabitants ≥ 65 years of age (deaths in people < 20 years old were too rare to provide an accurate estimate). Conclusions The annual incidence of epidermal necrolysis is higher than the one to five cases per million inhabitants usually reported. Such estimations could be helpful in establishing appropriate healthcare plans for people with epidermal necrolysis, in particular the need for specialized care units. What's already known about this topic? Few data are available regarding incidence of and mortality from epidermal necrolysis in the general population. Experts in epidermal necrolysis have recently proposed an annual incidence of one to five cases per million individuals. The overall mortality rate is usually reported to be between 10% and 20%. What does this study add? Using a four‐source capture–recapture method and data from a 14‐year period (2003–16), the annual incidence of and mortality from epidermal necrolysis were estimated to be 6·5 (95% confidence interval 4·1–8·9) and 0·9 (0·1–1·8) cases per million French inhabitants, respectively. Such estimations could be helpful in establishing appropriate healthcare plans, in particular the need for specialized care units.

show abstract

“…Duong et al . describe the long‐term follow‐up of a cohort of 32 patients who underwent objective testing of their respiratory function in the year following discharge from an acute admission with SJS, TEN or SJS/TEN overlap . They demonstrate that a significant number of such patients have abnormal pulmonary function tests, specifically diffusion capacities, noted at 3 months, with abnormalities sustained in a proportion of this cohort on retesting 6 months later.…”

mentioning

confidence: 99%

“…This month sees the publication of an important piece of research in the field of medical dermatology, specifically in the domain of Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS‐TEN) . With the imminent publication of the British Association of Dermatologists’ guidelines on the management of this disease spectrum, this paper provides a timely opportunity to reflect on an important extracutaneous aspect of SJS‐TEN, currently under‐recognized by clinicians both within and outside of dermatology.…”

mentioning

confidence: 99%

Extracutaneous manifestations and long-term sequelae of Stevens-Johnson syndrome/toxic epidermal necrolysis

Vercueil

Walsh

2015

Br J Dermatol

View full text Add to dashboard Cite

Stevens-Johnson syndrome and toxic epidermal necrolysis: follow-up of pulmonary function after remission

Abstract: More than half of patients with SJS/TEN displayed abnormalities on PFTs, mainly diffusion impairment, which was associated with higher initial skin surface detachment. These abnormalities were mostly asymptomatic and remained stable over time.

Cited by 26 publications

References 20 publications

The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis

The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis

Incidence of and mortality from epidermal necrolysis (Stevens–Johnson syndrome/toxic epidermal necrolysis) in France during 2003–16: a four‐source capture–recapture estimate

Extracutaneous manifestations and long-term sequelae of Stevens-Johnson syndrome/toxic epidermal necrolysis

Contact Info

Product

Resources

About