A 10-Year Experience With Toxic Epidermal Necrolysis

Jt, Schulz; Rl, Sheridan; Ryan, Colleen M.; Mackool, Bonnie T.; Rg, Tompkins

doi:10.1097/00004630-200021030-00004

Cited by 144 publications

(91 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…La fisiopatología sugiere que los metabolitos activos de los medicamentos se comportan como haptenos unidos a proteínas de las células epidérmicas con liberación de citoquinas, esto genera una reacción tóxica y una necrosis celular que induce a separación extensa de la epidermis y las mucosas (2,3,6). La existencia de factores genéticos se ha sustentado en la aparición de casos familiares de SSJ/NET asociados a diversos haplotipos, sobre todo el HLA-B12 (7) y el uso de algunos fármacos se ha visto implicado en la etiología de más del 80% de los casos estudiados.…”

Section: Discussionunclassified

“…La distribución es mundial, afectando a todas la razas, edades y ambos sexos, el riesgo anual es de 0,4 a dos casos por millón y la mortalidad puede llegar a 70% (2,3). El uso de fármacos se ha visto implicado en la etiología en más del 80% de los casos estudiados; están descritos la mayoría tras el uso antibióticos en 80% y anticonvulsivantes en 15% (3).…”

Section: Introductionunclassified

See 1 more Smart Citation

Necrolisis epidérmica tóxica inducida por Difenilhidantoína. A propósito de un caso

Cubas¹,

Pacheco²

2017

Rev Med Hered

View full text Add to dashboard Cite

RESUMENLa Necrólisis Epidérmica Tóxica (NET) o síndrome de Lyell y el Síndrome de Stevens-Johnson (SSJ) constituyen un espectro de la misma enfermedad, ambas comparten aspectos etiopatogénicos, histológicos y terapéuticos. La NET es un síndrome agudo de escasa ocurrencia y representa probablemente la entidad dermatológica más grave conocida, cursa clínicamente con la formación de ampollas, necrosis de la epidermis y desprendimiento de la misma. Las manifestaciones sistémicas son fundamentalmente respiratorias, gastrointestinales y renales; la mortalidad es de 70%. Generalmente es desencadenada por fármacos, especialmente los anticonvulsivantes como la Difenilhidantoína. Se presenta el caso de un varón de 60 años, con antecedente de crisis convulsivas que fueron tratadas con Difenilhidantoína, quien desarrolló posteriormente un exantema vesículo-ampollar cuya presentación, distribución, compromiso sistémico,asociación temporal con el fármaco y el grado de extensión, apoyaron al diagnóstico de NET.PALABRAS CLAVE: Difenilhidantoína, Síndrome de Stevens-Johnson, efectos colaterales y reacciones adversas relacionados con medicamentos. (Fuente: DeCS BIREME). SUMMARYToxic epidermal necrolysis (TEN) or Lyell´ syndrome and Stevens-Johnson´s syndrome are variants of a same disease sharing pathogenic, histopathological and therapeutic approaches. TEN is an acute and rare presentation and it is considered the most severe dermatologic entity, characterized by blisters, necrosis and sloughing of the dermis. Systemic manifestations are basically respiratory, gastrointestinal and renal; mortality is 70%. TEN is usually druginduced, especially by antiseizure medications including diphenylhydantoin. We present the case of a 60 year-old male treated with diphenylhydantoin for seizures that developed a bullous rash whose clinical presentation; body distribution; systemic involvement and temporal association supported the diagnosis of TEN.

show abstract

Section: Discussionunclassified

Section: Introductionunclassified

Necrolisis epidérmica tóxica inducida por Difenilhidantoína. A propósito de un caso

Cubas¹,

Pacheco²

2017

Rev Med Hered

View full text Add to dashboard Cite

show abstract

“…The unit has expertise in providing analgesia, maintaining fluid and electrolyte balance and preventing and treating superinfection. It has been recently noted that in contrast to burns, TEN affects the epidermis and hence fluid and electrolyte requirements are less than for burns of the same extent [121]; initial administration of 2 ml/kg/%TBSA is usually sufficient [122]. Additional nutritional requirements result from loss of nitrogen and energy from the wound exudate, the hypermetabolic response of TEN and sepsis and the promotion of wound healing.…”

Section: Supportive Carementioning

confidence: 99%

“…Prophylactic antibiotics are not advised as they predispose to the emergence of resistant organisms [121]. Hence, repeated cultures of the skin, blood and other sites guide the need for antibiotic therapy.…”

Section: Supportive Carementioning

confidence: 99%

Severe Cutaneous Adverse Reactions

Fernando¹

2013

Skin Biopsy - Diagnosis and Treatment

View full text Add to dashboard Cite

“…On the other hand, the mortality for those patients with SSJ is from 2 to 10% and in the patients with NET, it is approximately 34% [36] . In the last cases, sepsis and hypovolemia are the principal cause of death and when this diagnosis is suspected, patients should be referred immediately to a specialized intensive care or burn units [47] .…”

Section: Histological Findingsmentioning

confidence: 99%

Erythema Multiforme Minor: A Revision

Oliveira¹,

Zucoloto²

2008

American J. of Infectious Diseases

View full text Add to dashboard Cite

Abstract:The term Erythema Multiforme (EM) includes a wide and controversial variety of clinical expressions at the present time. This study revises the EM minor characteristics according to the most important publications found in literature. Erythema Multiforme is a distinct dermatologic hypersensitivity pathology characterized by cutaneous or mucous lesions and eventually it can also involve both. In their more severe forms, they appear with occasional visceral involvements. In the EM minor only one mucous membrane is affected and usually is the oral mucosa. When occur in the skin, the lesions usually appear symmetrically in the extremities, in a target form, could be continuous or recurrent and none additional systemic involvement is present for both cases. Nowadays, many authors separate etiologically the several manifestations of the EM spectrum. However, no clinical definition is still accepted thoroughly, making more difficult the comparisons of etiological and clinical aspects, histopathological studies and therapeutic protocols. For the present work, we tried to elucidate through an extensive literature revision some historical and current aspects of EM, focusing mainly the EM minor and its frequent association to HSV (Herpes Simplex Virus), with their diagnostic characteristics and current therapeutics, to facilitate the physician understanding and to favor future researches about this disease.

show abstract

A 10-Year Experience With Toxic Epidermal Necrolysis

Cited by 144 publications

References 4 publications

Necrolisis epidérmica tóxica inducida por Difenilhidantoína. A propósito de un caso

Necrolisis epidérmica tóxica inducida por Difenilhidantoína. A propósito de un caso

Severe Cutaneous Adverse Reactions

Erythema Multiforme Minor: A Revision

Contact Info

Product

Resources

About