Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990–1992): Structure and results of a population-based registry

Rzany, Berthold; Mockenhaupt, Maja; Baur, Susan; Schröder, Werner; Stocker, Ulrich; Müeller, Jens-Dominik; Holländer, Norbert; Bruppacher, R.; Schöpf, Erwin

doi:10.1016/0895-4356(96)00035-2

Cited by 323 publications

(217 citation statements)

References 15 publications

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“…9 In a study in Germany from 1990 to 1992, the calculated incidence of TEN and SJS together was 1.89 per 1 million people per year. 12 These exfoliative disorders occur in all age groups; however, the incidence is increased in the elderly and in females. 1,3,8,24 The reported incidence of TEN in children is lower than in adults.…”

Section: Discussionmentioning

confidence: 99%

“…8 -11 Antibacterials and antifungals (36%), anticonvulsants (24%), analgesics, nonsteroidal anti-inflammatory agents (38%), and even corticosteroids (14%) have been suspected of causing the disease process. [11][12][13] The underlying pathophysiologic mechanism is unclear. The histologic characteristics of TEN include dermoepidermal separation resembling a blistering scald burn, followed by necrosis and shedding of the epidermis.…”

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confidence: 99%

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Treatment of Extensive Toxic Epidermal Necrolysis in Children

et al. 2001

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ABSTRACT. Objective. Toxic epidermal necrolysis (TEN) is a rare but life-threatening disease of the skin and mucous membranes. We report our experience in the treatment of pediatric TEN patients with early debridement of necrotic skin and coverage with human allograft skin.Methods. From 1984 to 2000, 15 children (6 girls, 9 boys, 7.2 ؎ 1.5 years) with a histologic diagnosis of TEN and involvement of >30% total body surface area were treated at the Shriners Hospitals for Children in Galveston. All were treated in a specialized pediatric burn intensive care unit after our standard treatment protocol, including operative debridement of sloughing skin and allografting within 24 hours of admission. Outcome parameters were mortality, length of hospital stay, wound healing, clinical complications, causative drugs, corticosteroid use, and delay in referral to a burn center. Results. Taking a new medication (antibiotics, anticonvulsive drugs) was associated with all cases of TEN.Patients who were treated with early debridement and coverage with allograft skin showed no wound infection, and overall mortality was 7%. Total length of hospital stay was 26 ؎ 3 days. Long-term sequelae were changes in skin pigmentation (100%), ophthalmologic problems (40%), and diffuse itching early after wound healing (53%).Conclusion. Although a rare disease in children, TEN was managed successfully in a burn center environment, using early debridement and wound coverage with allograft skin as a biological dressing. The use of corticosteroids and referral patterns seems unchanged during the past 2 decades, indicating an additional need for information and education about the disease. Pediatrics 2001; 108:1162-1168; toxic epidermal necrolysis, children, burn center, mortality, biological dressing.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Treatment of Extensive Toxic Epidermal Necrolysis in Children

et al. 2001

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“…4 A incidência da SSJ é estimada em cerca de um a três casos por milhão de habitantes ao ano. 20,21,22 Pode ser precedida por erupção maculopapulosa discreta semelhante ao exantema morbiliforme. 19 É possível a formação de bolhas, geralmente não determinando descolamento epidér-mico maior do que 10% da superfí-cie corpórea.…”

Section: A Síndrome De Stevens-johnson (Ssj)unclassified

“…4 Incidence of SJS is estimated at roughly one in three cases per million residents yearly. 20,21,22 It may be preceded by a discreet maculopapulous eruption similar to exanthema morbilliform. 19 Blister formations are possible, though usually not determined by an epidermal detachment of over 10% of the body surface.…”

Section: O Espectro Clínico Da Síndrome De Stevensjohnson E Da Necrólmentioning

confidence: 99%

Reações cutâneas graves adversas a drogas - aspectos relevantes ao diagnóstico e ao tratamento - Parte I - Anafilaxia e reações anafilactóides, eritrodermias e o espectro clínico da síndrome de Stevens-Johnson & necrólise epidérmica tóxica (Doença de Lyell)

Criado

Vasconcellos

et al. 2004

An. Bras. Dermatol.

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As reações cutâneas graves adversas a droga (RCGAD) são as que geralmente necessitam de internação hospitalar, por vezes em unidade de terapia intensiva ou de queimados, com observação minuciosa dos sinais vitais e da função de órgãos internos. O objetivo é descrever essas reações, facilitando seu reconhecimento e tratamento. Fazem parte desse grupo a anafilaxia, a síndrome de Stevens-Johnson (SSJ), a necrólise epidérmica tóxica (NET) e, dependendo do envolvimento sistêmico, as eritrodermias. Neste artigo, são abordados as características clínicas e o tratamento de algumas reações adversas a droga: anafilaxia, as eritrodermias, a síndrome de Stevens-Johnson (SSJ) e a necrólise epidérmica tóxica (NET).

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“…[11][12][13] Most HSR cases occur during the first eight weeks of treatment. [14][15][16][17] HSRs refer to dose-independent, idiosyncratic, severe adverse drug reactions (ADR). 18,19 Clinically, a triad of fever, rash and organ manifestation defines a "true" HSR.…”

Section: Introductionmentioning

confidence: 99%