Burn center admissions of patients with autoimmune rheumatic diseases: clinical characteristics and outcomes

Parperis, Konstantinos; Bhattarai, Bikash; Hadi, Mohanad; Malla, Sawjanya; Barlingay, Gauri; Ramakuri, Monica; Foster, Kevin N

doi:10.1007/s00296-020-04617-1

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…Other known risk A B A B TEN/SLE was triggered in the two patients with systemic lupus erythematosus. The study showed that patients with autoimmune rheumatic diseases were more likely to develop TEN/SLE under the influence of a drug (11). In over onethird of SJS/TEN cases, however, no risk factor can be identified (12).…”

Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis with systemic lupus erythematosus: case report and review of the literature

Fan¹,

Zhai²,

Ma³

et al. 2022

Ann Palliat Med

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Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are potentially fatal mucocutaneous diseases characterized by extensive necrosis and exfoliation of the epidermis. TEN and SJS are most often caused by various kinds of drugs. Other risk factors for SJS/TEN include pneumonia infection, HIV infection, genetic factors, underlying immune diseases, and tumors. SJS and TEN were first identified in 1922, but at present, a widely recognized view is that SJS and TEN represent phases in the continuous progress of the same disease. SJS/TEN has a very high mortality, but is rare, and cases of SJS/TEN combined with systemic lupus erythematosus (SLE) are even less common. Occasionally, acute cutaneous manifestations of SLE and SJS/TEN can be phenotypically similar, both causing extensive epidermal necrosis. In this paper, we present a recent case of a 32-year-old female SLE patient with a druginduced (the health product, astaxanthin) TEN/SJS. To provide context to this case, we have reviewed relevant case studies published in English, accessed via PubMed databases. The search covers all published case studies from 1988 to 2019. We collected a total of 30 cases in the literature, and analyzed their characteristics from the aspects of gender, suspicious medication history, and treatment in order to expand clinicians' approach to diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis with systemic lupus erythematosus: case report and review of the literature

Fan¹,

Zhai²,

Ma³

et al. 2022

Ann Palliat Med

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“…There is a considerable lack of research concerning burn management in the setting of a severe exacerbation of SLE requiring a multi-agent immunosuppressive regimen. In one of the few studies to assess burn management in patients with concomitant autoimmune rheumatic diseases, including SLE, 2.7% of subjects that had a history of autoimmune rheumatic disease were more likely to require additional therapeutic interventions such as renal replacement and enteral nutrition [ 12 ]. In this patient, therapeutic measures included placing the patient on a renal diet, pain management for burn and nephritis-associated pain, anticoagulation due to renal vein thrombosis, IVIG and steroids to stifle an overactive immune response, and management of complications due to GI bleeding and leukopenia.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the elicitation of an inflammatory cascade of events is paramount to the body's response to tissue injury. Importantly, immunosuppressive drug regimens used to treat SLE, such as long-term systemic corticosteroids, methotrexate, mycophenolate mofetil, azathioprine, and drugs interfering with the Interleukin-2 mediated immune response (e.g., voclosporin), as well as the presence of SLE per se, counteract and impair the wound healing process [8][9][10][11][12][13]. This potentially complicates the management of burn patients with comorbid SLE and necessitates special consideration on how to approach burn management in this unique population.…”

Section: Introductionmentioning

confidence: 99%

Burn Management in a Patient With Acute Exacerbation of Comorbid Systemic Lupus Erythematosus

Davis¹,

Pang²,

Abidi³

et al. 2023

Cureus

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A 28-year-old female presented to the burn unit with 2% total body surface area second-degree burns to the right flank and right breast after accidentally spilling coffee on herself while hospitalized for an acute exacerbation of systemic lupus erythematosus (SLE) in the form of neuromyelitis optica spectrum disorder. We document her inpatient management, which was challenging because of the contradictory relationship between typical management of SLE exacerbations (i.e., immunosuppressive medication regimens) and the body’s post-burn healing process, which is inherently inflammatory in nature. Even with a high-dose immunosuppressive medication regimen, our patient’s second-degree burns healed with non-operative management without significant adverse events. Adding to a small yet growing body of literature addressing the clinical presentation and management of burn wounds in the setting of an acute SLE exacerbation, our case suggests that clinicians must carefully weigh the risks of surgical intervention with those of non-operative management when approaching burn care during an acute rheumatologic disease flare up.

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Drug allergy and autoimmune diseases

Watanabe

Yamaguchi

2022

Allergology International

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Burn center admissions of patients with autoimmune rheumatic diseases: clinical characteristics and outcomes

Cited by 3 publications

References 24 publications

Toxic epidermal necrolysis with systemic lupus erythematosus: case report and review of the literature

Toxic epidermal necrolysis with systemic lupus erythematosus: case report and review of the literature

Burn Management in a Patient With Acute Exacerbation of Comorbid Systemic Lupus Erythematosus

Drug allergy and autoimmune diseases

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