Fatal toxic epidermal necrolysis probably related to glimepiride in a patient with a medical history of hypersensitivity to sulfamethoxazole–trimethoprim

Ouni, Bouraoui; Fathallah, Neila; Ben-Sayed, Nesrine; Abdessayed, Nihed; Slim, Raoudha; Sriha, Badreddine; Salem, Chaker Ben

doi:10.1111/bcp.14499

Cited by 6 publications

(7 citation statements)

References 7 publications

(4 reference statements)

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“…Similarly, participants who underwent any debridement were allocated to the ‘debridement’ group. These debrided participants represented centres practising conservative wound care 35‐42 and centres where routine debridement is practised 29,32,43,44,45,46,47,48,49,50,51,52,53,54,55 …”

Section: Methodsmentioning

confidence: 99%

“…Similarly, participants who underwent any debridement were allocated to the 'debridement' group. These debrided participants represented centres practising conservative wound care [35][36][37][38][39][40][41][42] and centres where routine debridement is practised. 29,32,43,44,45,46,47,48,49,50,51,52,53,54,55 Where the data were not available in the article, the study authors were contacted via email/phone to provide this information.…”

Section: Data Collection and Data Itemsmentioning

confidence: 99%

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An individual patient data meta‐analysis of wound care in patients with toxic epidermal necrolysis

Lee,

Mallitt,

Fischer

et al. 2023

Aust J Dermatology

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Toxic epidermal necrolysis (TEN) involves extensive mucocutaneous loss, and care is supportive. The approach to wound care includes surgical debridement or using dressings while leaving the epidermis intact. Robust evidence for either approach is lacking. We compared surgical debridement to the use of dressings while leaving the epidermis in situ (referred to hereon as dressings) in adult patients with TEN. The primary outcome assessed was mortality. The secondary outcome was time to re‐epithelialisation. The impact of medications was evaluated. An individual patient data (IPD) systematic review and meta‐analysis was undertaken. A random effects meta‐analysis and survival analysis for IPD data examined mortality, re‐epithelisation time and the effect of systemic medications. The quality of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation (GRADE). PROSPERO: CRD42021266611 Fifty‐four studies involving 227 patients were included in the systematic review and meta‐analysis, with a GRADE from very low to moderate. There was no difference in survival in patients who had surgical debridement or dressings (univariate: p = 0.91, multivariate: p = 0.31). Patients who received dressings re‐epithelialised faster than patients who underwent debridement (multivariate HR: 1.96 [1.09–3.51], p = 0.023). Intravenous immunoglobulin (univariate HR: 0.21 [0.09–0.45], p < 0.001; multivariate HR: 0.22 [0.09–0.53], p < 0.001) and cyclosporin significantly reduced mortality (univariate HR: 0.09 [0.01–0.96], p = 0.046; multivariate HR: 0.06 [0.01–0.73], p = 0.028) irrespective of the wound care. This study supports the expert consensus of the dermatology hospitalists, that wound care in patients with TEN should be supportive with the epidermis left intact and supported with dressings, which leads to faster re‐epithelialisation.

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Section: Methodsmentioning

confidence: 99%

Section: Data Collection and Data Itemsmentioning

confidence: 99%

An individual patient data meta‐analysis of wound care in patients with toxic epidermal necrolysis

Lee,

Mallitt,

Fischer

et al. 2023

Aust J Dermatology

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“…Only one case report of TEN was found in literature. A week after a 76-year-old patient started glimepiride, she developed a local pruritic skin rash that progressed to generalized erythema with multiple brown lesions and blisters and mucosal involvement [27]. Skin biopsy and a negative workup for other causes confirmed the diagnosis of TEN and the Naranjo probability scare for adverse drug reactions indicated that glimepiride-induced TEN was the probable cause.…”

Section: Sulfonylureasmentioning

confidence: 96%

“…Similar to metformin's CADRs profile, most of the sulfonylureas cause immunologic-related eruptions. However, different from metformin, the largest grouping within this category is a variety of loosely classified exanthematous reactions, including cases of TEN [27], psoriasiform rash [28], exanthematous pustulosis [29], pigmented purpuric dermatosis [30], and erythroderma [31], and lichenoid reactions [31][32][33][34][35]. Other types of immunologic reactions fell within the vasculitic group [36,37] and blistering reaction pattern (erythema multiforme) [38].…”

Section: Sulfonylureasmentioning

confidence: 99%

Cutaneous Reactions to Antidiabetic Agents: A Narrative Review

Boccardi

Shubrook

2022

Diabetology

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Diabetes is a common and complex disease affecting multiple organ systems throughout the body. With a consensus in care guidelines emphasizing the importance of glycemic control in determining the disease progression, people with diabetes worldwide have been placed on medication regimens targeting glucose stability from a variety of pathophysiologic pathways. Each of these medications also possesses its own potential for adverse events. In recent years, there has been increased reports of skin reactions to diabetes medications, adding to the more widely known eruptions such as insulin-induced lipohypertrophy and contact dermatitis of subcutaneous injections. The authors searched PubMed, Google, and Embase for articles including adverse reactions to anti-hyperglycemic medications. Key words and titles searched included, “antidiabetic drugs”, “skin reactions”, “adverse drug reactions”, “allergic reactions”, “diabetes”, “metformin”, “insulin”, “DPP4 inhibitors”, “thiazolindineones”, “sulfonylureas”, “SGLT2 inhibitors”, “GLP-1 agonists”, “diabetic medication”, “injection site reactions”. As a result, a total of 59 papers are included in this review. The great majority were case reports ranging from benign fixed drug eruptions to severe cutaneous reactions that threaten patients’ lives. Increasing physician awareness of both the potential for, and presentation of, such reactions to diabetes medications can reduce hospitalizations and optimize care in an already vulnerable patient population.

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“…Some case reports have implicated glipizide and glimepiride in SJS/TEN [ 61 , 62 ]. However, European case-control studies have denied any significant risk of SJS/TEN with the use of sulfonylureas [ 24 ].…”

Section: Reviewmentioning

confidence: 99%

A Compilation of Drug Etiologies of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Abulatan,

Ben-David,

Morales-Colon

et al. 2023

Cureus

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are adverse reactions that affect the mucocutaneous surfaces by causing necrosis and detachment of the epidermis. The difference between SJS and TEN is in the percentage of the body surface area (BSA) affected. TEN is known to affect greater BSA than SJS. The pathogenesis of SJS/TEN is attributed to drug-specific cell-mediated cytotoxic reactions that directly and indirectly lead to keratinocyte apoptosis through mediators. Clinical presentation begins with influenza-like symptoms, with the disease affecting the skin, oral, ocular, and urogenital regions most frequently. Although SJS/TEN is mainly due to various drugs, infection and vaccination can also induce SJS/TEN. This review outlines a compilation of all drugs implicated in SJS/TEN cases based on studies, mainly in case reports and other study types. Drug classes implicated in SJS/TEN cases include antibiotics, anticonvulsants, antineoplastics, analgesics, and diuretics, among others. There is no fully established diagnostic modality for SJS/TEN; treatment is done mainly by withdrawing the offending agent. In addition to withdrawing the offending agent, a multidisciplinary care team is essential in managing these patients. Several pharmacologic modalities have also been proposed in treatment, but there is still insufficient evidence for the efficacy of one against the other.

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Fatal toxic epidermal necrolysis probably related to glimepiride in a patient with a medical history of hypersensitivity to sulfamethoxazole–trimethoprim

Cited by 6 publications

References 7 publications

An individual patient data meta‐analysis of wound care in patients with toxic epidermal necrolysis

An individual patient data meta‐analysis of wound care in patients with toxic epidermal necrolysis

Cutaneous Reactions to Antidiabetic Agents: A Narrative Review

A Compilation of Drug Etiologies of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

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