Allopurinol‐induced Toxic Epidermal Necrolysis

Dan, Michael; Jedwab, M; Peled, M.; Shibolet, Shlomo

doi:10.1111/j.1365-4362.1984.tb05689.x

Cited by 17 publications

(4 citation statements)

References 17 publications

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“…The literature reports many studies about the drugs responsible for this syndrome. Among these, allopurinol has frequently been cited as potential trigger (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

“…The most frequently associated triggers are antibiotics (trimethoprim/sulfamethoxazole, beta‐lactams, tetracyclines, quinolones), aromatic anticonvulsants (phenytoin, phenobarbital, carbamazepine), nevirapine, abacavir, and nonsteroidal anti‐inflammatory drugs (3–11). Also allopurinol has been frequently associated to the occurrence of TEN (12–22). …”

mentioning

confidence: 99%

“…The most frequently associated triggers are antibiotics (trimethoprim ⁄ sulfamethoxazole, beta-lactams, tetracyclines, quinolones), aromatic anticonvulsants (phenytoin, phenobarbital, carbamazepine), nevirapine, abacavir, and nonsteroidal anti-inflammatory drugs (3)(4)(5)(6)(7)(8)(9)(10)(11). Also allopurinol has been frequently associated to the occurrence of TEN (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). TEN is characterized by erythematous rash, formation of bullae, separation of large sheets of epidermidis from the dermis, purulent conjunctivitis, and mucositis of the mouth and genital area (23).…”

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confidence: 99%

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Death Caused by Toxic Epidermal Necrolysis (Lyell Syndrome)

Ventura

Fracasso

Leoncini

et al. 2010

Journal of Forensic Sciences

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Toxic epidermal necrolysis (TEN) is characterized by fever, scalded appearance of the skin, and epidermolysis associated to blister formation and exfoliation, and it is caused by hypersensitivity reaction to a drug. The authors report two cases of death as a result of TEN; both referred to old aged women treated with a polytherapy including allopurinol. Both patients displayed erythematous skin lesions similar to scald burns and epidermolysis at the face, chest, and abdomen and died shortly after hospitalization. Autopsy findings and histological examinations revealed epidermal necrolysis and confirmed the clinical diagnosis. A strict time-correlation between allopurinol administration and symptoms was evidenced. Because of its iatrogenic origin, TEN often arises suspicions of medical liability; however, because of its unpredictable nature, the occurrence of this syndrome cannot be ascribed to the medical staff whose main task is the rapid diagnosis and the correct management.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Death Caused by Toxic Epidermal Necrolysis (Lyell Syndrome)

Ventura

Fracasso

Leoncini

et al. 2010

Journal of Forensic Sciences

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“…Allopurinol vermag bei bis zu 10% der Patienten Arzneiexantheme unterschiedlicher Morphologie und Schweregrade auszulösen, wobei der Entwicklungszeitraum von wenigen Tagen bis zu mehreren Monaten Allopurinoleinnahme reichen kann: (Urtikaria [24], Angioödem [39], fixes Arzneimittelexanthem [16], Erythema exsudativum multiforme [27], Stevens-Johnson-Syndrom [32], toxische epidermale Nekrolyse [6], thrombozytopenische Purpura [8], Lupus erythematodes [28], lichenoide Arzneireaktion [12], Lichen ruber planus [29], orale lichenoide Eruption [9], Onycholyse [29], pustulöse Arzneiexantheme [38], Polyarteriitis-nodosa-ähnliches Syndrom [17]). Das Auftreten einer akuten GvH-ähnlichen Arzneireaktion ist extrem selten und von der akuten GvHR weder klinisch noch histologisch oder immunhistochemisch zu unterscheiden [27].…”

Section: Kasuistik Vorgeschichteunclassified

Allopurinol als Auslöser einer akuten Graft- versus-Host-ähnlichen Arzneimittelreaktion

et al. 1998

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Although drug eruptions resembling graft-versus-host disease are rare, GvH-like reactions to the sulfhydryl group of drugs (penicillamine, captopril, gold sodium), phenobarbital and hepatitis vaccine have been described. Clinical reports concerning acute GvH-like drug rash are very uncommon and restricted to acetylsalicylic acid and spironolactone. We report on a patient who developed an acute GvH-like drug reaction caused by allopurinol. To our knowledge this variant of cytotoxic drug eruption has not yet been reported in literature.

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The Culprit Drugs in 87 Cases of Toxic Epidermal Necrolysis (Lyell's Syndrome)

Guillaume¹

1987

Arch Dermatol

202

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Between 1972 and 1985, 87 patients with toxic epidermal necrolysis (TEN) were admitted to the dermatological intensive care unit at Hôpital Henri Mondor, Créteil, France. The culpable drug was determined by standardized criteria. Only three patients had received no drugs before the onset of TEN. Most patients (71 of 87) were receiving more than one drug. Patients had taken an average of 4.4 +/- 3.4 drugs each. A culpable drug was determined in 67 patients (77%). The mean time from first drug administration to onset of TEN was 13.6 +/- 8.4 days. The culprit drugs included the following: sulfonamides, 18 cases, and especially sulfamethoxazole and trimethoprim, 12; anticonvulsants, seven (barbiturates and carbamazepine only); nonsteroidal anti-inflammatory drugs, 29 (especially the phenylbutazone derivative, 16, and oxicam derivatives, 10); allopurinol, three; chlormezanone, three; and others, seven. Aspirin, antipyretics, and antibiotics are infrequently implicated in this series. The pattern of culprit drugs changed with years. The level of sulfonamide-related TEN remained the same, while incidence of nonsteroidal anti-inflammatory drug-induced TEN increased sharply, the introduction of oxicam derivatives being in part responsible.

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Allopurinol‐induced Toxic Epidermal Necrolysis

Cited by 17 publications

References 17 publications

Death Caused by Toxic Epidermal Necrolysis (Lyell Syndrome)

Death Caused by Toxic Epidermal Necrolysis (Lyell Syndrome)

Allopurinol als Auslöser einer akuten Graft- versus-Host-ähnlichen Arzneimittelreaktion

The Culprit Drugs in 87 Cases of Toxic Epidermal Necrolysis (Lyell's Syndrome)

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