Patofisiologi dan Manajemen Terapi Sindrom Stevens-Johnson(SSJ) dan Nekrolisis Epidermal Toksik (NET)

Diana, Rina; Irawanto, Muhammad Eko

doi:10.56951/medicinus.v33i2.53

Cited by 1 publication

(4 citation statements)

References 24 publications

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“…There is no best-specialized therapy for TEN until now. 19 In this case, tuberculosis drugs were stopped temporarily. Supportive care includes: maintaining fluid, electrolytes, optimal ambient temperature of 28-30°C, nutrition, aseptic skincare without debridement, and eye care.…”

Section: Discussionmentioning

confidence: 95%

“…There is no best-specialized therapy for TEN until now. 19 In this case, tuberculosis drugs were stopped temporarily.…”

Section: Discussionmentioning

confidence: 95%

“…23 Treatment with plasmapheresis reduced the severity of TEN in patients, 24 however, the efficacy of plasmapheresis in toxic epidermal necrolysis should be further evaluated. 19,22 Table 1. The use of total plasma exchange in toxic epidermal necrolysis cases.…”

Section: Discussionmentioning

confidence: 99%

“…From epidemiological studies of TEN throughout Japan from 2005 to 2007, plasmapheresis is now only used as a last resort in TEN patients who do not improve with standard therapy, including high-dose corticosteroids or adequate IVIG, or for patients with severe clinical complications such as encephalopathy hepatic and in patients with TEN involving more than 70% BSA. 19 , 22 Previous studies that reported the use of plasmapheresis in TEN patients are presented in Table 1 . Of 119 patients, antibiotics triggered TEN in 19.3% cases, while NSAID medication caused TEN in 14.3% cases.…”

Section: Discussionmentioning

confidence: 99%

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Case Report: A successful case of toxic epidermal necrolysis treated with plasmapheresis therapy

et al. 2022

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Toxic epidermal necrosis (TEN) is rare and can be life-threatening for patients. Appropriate management of TEN patients could give optimal results and prevent complications. One treatment modality for TEN is plasmapheresis, which is rarely available in most cases with severe TEN. Here we reported a successful treatment of severe TEN with plasmapheresis. A 40-year-old woman under tuberculosis therapy complained of shortness of breath that began four days prior to hospital admission and worsened ever since. The patient's skin was peeling with red spots and rashes all over the body for a week. During the examination, the patient was compos mentis, and the SCORTEN score was 2 with 12.1% risk of mortality rate. Dermatological examination of the face, trunk and extremities found extensive erosions, loose bullae filled with clear fluid, brown crusts, and generalized distribution with more than 30% epidermolysis. The patient was diagnosed with toxic epidermal necrolysis caused by antituberculosis therapy. We treated the patient by discontinuing the suspected drugs and administering the corticosteroids, but no improvement was observed. The patient underwent two cycle plasmaphereses with 5% albumin, resulting in 1.2 liter of plasma exchange. Re-epithelialization was observed after three days, and the patient was discharged on day 8. This case-report highlights the important role of plasmapheresis in treating the TEN patients. However, a study with larger sample sizes is warranted to validate the efficacy of plasmapheresis in TEN.

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Section: Discussionmentioning

confidence: 95%

“…There is no best-specialized therapy for TEN until now. 19 In this case, tuberculosis drugs were stopped temporarily.…”

Section: Discussionmentioning

confidence: 95%