Dark skin phototype is associated with more severe ocular complications of Stevens–Johnson syndrome and toxic epidermal necrolysis

Thorel, D.; Delcampe, A.; Ingen‐Housz‐Oro, Saskia; Hajj, Carla; Gabison, Éric; Chosidow, Olivier; Wolkenstein, Pierre; Royer, G; Ezzedine, Khaled; Muraine, M.; Gueudry, J.

doi:10.1111/bjd.17627

Cited by 8 publications

(2 citation statements)

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“…However, we recently showed that among patients requiring SLs, Fitzpatrick skin type V-VI was associated with more severe ophthalmological involvement (loss of visual acuity, symblepharons, trichiasis, corneal ulcerations). 7 Thus, rigorous ophthalmologic care is needed at the acute disease phase, but consensual guidelines are lacking. 4 Encouraging preliminary results have been obtained for amniotic membrane transplantation.…”

Section: Accepted Articlementioning

confidence: 99%

Disabling ocular sequelae of epidermal necrolysis: risk factors during the acute phase and associated sequelae

et al. 2019

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Section: Accepted Articlementioning

confidence: 99%

Disabling ocular sequelae of epidermal necrolysis: risk factors during the acute phase and associated sequelae

et al. 2019

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“…The main risk factors of severe long-term ocular sequelae are the severity of the initial ocular lesions and the overall severity of the acute phase [ 9 , 10 ]. Moreover, skin phototypes V and VI have recently been reported as an additional risk factor for more severe, long-term ocular complications [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Management of ocular involvement in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: french national audit of practices, literature review, and consensus agreement

Thorel

Ingen‐Housz‐Oro

Royer

et al. 2020

Orphanet J Rare Dis

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Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can lead to severe ophthalmologic sequelae. The main risk factor is the severity of the initial ocular involvement. There are no recommendations for ocular management during acute phase. We conducted a national audit of current practice in the 11 sites of the French reference center for toxic bullous dermatoses and a review of the literature to establish therapeutic consensus guidelines. We sent a questionnaire on ocular management practices in SJS/ TEN during acute phase to ophthalmologists and dermatologists. The survey focused on ophthalmologist opinion, pseudomembrane removal, topical ocular treatment (i.e. corticosteroids, antibiotics, antiseptics, artificial tear eye drops, vitamin A ointment application), amniotic membrane transplantation, symblepharon ring use, and systemic corticosteroid therapy for ophthalmologic indication. Nine of 11 centers responded. All requested prompt ophthalmologist consultation. The majority performed pseudomembrane removal, used artificial tears, and vitamin A ointment (8/9, 90%). Combined antibiotic-corticosteroid or corticosteroid eye drops were used in 6 centers (67%), antibiotics alone and antiseptics in 3 centers (33%). Symblepharon ring was used in 5 centers (55%) if necessary. Amniotic membrane transplantation was never performed systematically and only according to the clinical course. Systemic corticosteroid therapy was occasionally used (3/9, 33%) and discussed on a case-by-case basis. The literature about ocular management practice in SJS/ TEN during acute phase is relatively poor. The role of specific treatments such as local or systemic corticosteroid therapy is not consensual. The use of preservatives, often present in eye drops and deleterious to the ocular surface, is to be restricted. Early amniotic membrane transplantation seems to be promising.

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Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Ingen‐Housz‐Oro¹,

Duong²,

Chosidow³

2022

Drug Eruptions

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Dark skin phototype is associated with more severe ocular complications of Stevens–Johnson syndrome and toxic epidermal necrolysis

Cited by 8 publications

References 8 publications

Disabling ocular sequelae of epidermal necrolysis: risk factors during the acute phase and associated sequelae

Disabling ocular sequelae of epidermal necrolysis: risk factors during the acute phase and associated sequelae

Management of ocular involvement in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: french national audit of practices, literature review, and consensus agreement

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

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