Management of stevens-johnson syndrome-toxic epidermal necrolysis: Looking beyond guidelines!

Kumar, Rajesh S.; Das, Anupam; Das, Sudip

doi:10.4103/ijd.ijd_583_17

Cited by 33 publications

(6 citation statements)

References 109 publications

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“…Maintaining electrolyte balance and proper wound care are important aspects of management. Early use of corticosteroids within 24-48 hours of symptom onset has been shown to have a good outcome, as has the use of other immunomodulators such as IVIG, cyclosporine, tacrolimus, and cyclophosphamide [12]. The survival rate is shown to be significantly higher in patients who were transferred to the burn unit within seven days after disease onset [5].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Pertuzumab-Induced Toxic Epidermal Necrolysis

Jiffry¹,

Pires²,

Perozo³

et al. 2023

Cureus

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Pertuzumab is a targeted therapy drug that is employed in the management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer and works by blocking the ability of cancer cells to receive growth and proliferation signals. Toxic epidermal necrolysis (TEN) is a severe cutaneous manifestation characterized by widespread erythema, necrosis, and bullous detachment of the skin involving more than 10% of the body surface area (BSA) and may be precipitated by an immunologic response to the administration of certain medications. However, TEN development as a consequence of HER2 inhibitor therapy has not been described in the existing literature. A 44-year-old female with a history of metastatic breast cancer to the liver presented with a diffuse blistering rash following a first-time administration of pertuzumab three days prior. Her rash began as painful and pruritic blisters 12 hours after the last infusion of pertuzumab and progressed to involve her arms, chest, groin, and thighs with a positive Nikolsky sign. She was managed supportively with high-dose steroids and antihistamines, and although her hospital course was complicated by hypotension requiring pressor support, she gradually made a full recovery and was released to a rehabilitation facility.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Pertuzumab-Induced Toxic Epidermal Necrolysis

Jiffry¹,

Pires²,

Perozo³

et al. 2023

Cureus

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“…Long-term problems can also include impaired taste, difficulty urinating, and genital abnormalities. Alterations in skin coloration, dryness of the skin, and mucous membranes, along with hair loss, are also observed [38,39,40]. Multiple recurrences of SJS are rare and occurred in 1.4% of cases in a 10year population-based cohort study [41].…”

Section: Review Stevens-johnson Syndromementioning

confidence: 99%

Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review

Fabian,

Maddox,

Robicheaux

et al. 2024

Cureus

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Stevens-Johnson syndrome (SJS) is a severe and potentially debilitating skin reaction frequently related to medication use. Allopurinol and angiotensin-converting enzyme (ACE) inhibitors are commonly prescribed medications for prevalent health conditions worldwide, and their interaction associated with SJS warrants further investigation. A comprehensive literature search was performed to investigate cases as studies related to SJS occurring in patients with concomitant use of allopurinol and ACE inhibitors. We identified case reports and studies detailing hypersensitivity reactions, including SJS, attributed to a combination of allopurinol and ACE inhibitors. Despite the drug-drug interactions or lack thereof seen in patient populations, there is no definitive evidence of a pharmacokinetic interaction between allopurinol and ACE inhibitors. We were only able to find one case report specifically detailing SJS in a patient on combined ACE inhibitors and allopurinol. While the exact mechanism of the interaction is unclear, those reported cases of severe hypersensitivity reactions suggest a previous history of impaired renal function as a predisposing factor in the development of SJS. The potential risk of SJS with coadministration of ACE inhibitors and allopurinol is a drug-drug interaction that physicians should be aware of. This topic requires additional attention to determine if this drug combination should be avoided entirely in certain patients.

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“…Drugs account for nine out of ten cases of SJS/TEN (Barvaliya et al, 2011;Patel et al, 2013). SJS/TEN are associated with a high incidence of mortality (Kumar et al, 2018). The earlier the causative drug is withdrawn, the better is the prognosis for SJS/ TEN (Garcia-Doval et al, 2000).…”

Section: Single Ingredientmentioning

confidence: 99%

Suspected cutaneous adverse drug reactions reported with traditional medicines: analysis of data for United Nations Asia region from WHO VigiBase

Barvaliya¹,

Chetan²,

Chandan³

et al. 2023

Front. Pharmacol.

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Background: Data on traditional medicine-induced cutaneous adverse drug reactions (ADRs) is very scarce. The current secondary analysis based on the WHO database (VigiBase) of individual case safety reports (ICSRs) focuses on the suspected cutaneous ADRs linked to traditional medicines (TMs).Methods: All the ICSRs reported between 1st January 2016 and 30th June 2021 from the UN Asia region in VigiBase where at least one TM was suspected to cause cutaneous ADRs were included in the study. Data regarding demographic details, suspected drug, adverse reaction as per MedDRA term, the seriousness of the reaction, de-challenge, re-challenge, and clinical outcome for suspected cutaneous ADRs associated with TM were obtained from VigiBase and analyzed for frequency of reported events and suspected medicines.Findings: Total 3,523 ICSRs with 5,761 ADRs related to “skin and subcutaneous tissue disorders” were included in the analysis. Amongst these, 6.8% of ICSRs were reported as serious. Pruritus (29.6%), rash (20.3%), urticaria (18.9%), and hyperhidrosis (3.3%) were commonly reported ADRs. Artemisia argyi H.Lév. and Vaniot. (14.9%), Ginkgo biloba L. (5.1%), Vitis vinifera L. (4%), Vitex agnus-castus L. (3.8%), Silybum marianum (L.), Gaertn (3.5%), and Viscus album L. (2.7%) were some commonly suspected TMs for cutaneous ADRs. There were 46 cases of Stevens-Johnson syndrome and toxic epidermal necrolysis reported with TMs during the study period. Death was reported in 5 ICSRs.Interpretation: TMs are linked with various cutaneous ADRS ranging from pruritus to toxic epidermal necrolysis which may have serious consequences. TMs listed as suspected offending agents in this analysis, should be kept in mind while dealing with suspected cutaneous ADRs. Clinicians should be more vigilant in detecting and reporting events associated with TMs.

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Management of stevens-johnson syndrome-toxic epidermal necrolysis: Looking beyond guidelines!

Cited by 33 publications

References 109 publications

A Rare Case of Pertuzumab-Induced Toxic Epidermal Necrolysis

A Rare Case of Pertuzumab-Induced Toxic Epidermal Necrolysis

Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review

Suspected cutaneous adverse drug reactions reported with traditional medicines: analysis of data for United Nations Asia region from WHO VigiBase

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