Recurrence and Outcomes of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Children

Finkelstein, Yaron; Soon, Gordon S; Acuña, Patrick; George, Mathew; Pope, Elena; Itô, Shinya; Shear, Neil H.; Koren, Gideon; Shannon, Michael; Garcia‐Bournissen, Facundo

doi:10.1542/peds.2010-3322

Cited by 147 publications

(168 citation statements)

References 28 publications

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“…In the study of Finkelstein et al (25) conducted with children, the frequency of sequela was found to be 47% and it was reported that sequelas were most frequently in the form of hypopigmentation of the skin and formation of scar tissue. In our study, sequela changes in the form of wound scar and hyperpigmentation were observed after treatment only in two patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience

2016

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Aim: Stevens Johnson syndrome and toxic epidermal necrolysis are severe acute mucocutaneous diseases. In this study, we evaluated the clinical aspects of Steven Johnson syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap patients who admitted to our clinics in the last five years. Material and Methods: Eleven patients diagnosed as Stevens-Johnson syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap in Department of Pediatric Allergy in Uludağ University School of Medicine were included in this study. Clinical findings, laboratory tests and response to treatments were evaluated via electronic files. Results: Two of the patients had Stevens-Johnson syndrome, four had Stevens-Johnson syndrome/toxic epidermal necrolysis overlap, and five had toxic epidermal necrolysis. The median period for drug usage was 10 days (2-44 days). Herpes simpleks virus IgM antibody was detected two patients. The median healing time was 38 days 26-94 days). Maculopapular eruptions and oral mucositis were seen in all patients. Vesicul or bullae, epidermal detachment and ocular involvement in 10 of patients. Wound care, H1 antihistamine and methyl prednisolon were used in all patients, intravenous immunoglobulin were used in 7 patients and cyclosporine in 1 patient. Sequel lesions developed in 2 of the patients and there was no death. Conclusion: Anticonvulsants, antibiotics and non steroid anti-inflammatory drugs play a major role in the etiology of Stevens-Johnson syndrome and toxic epidermal necrolysis. Anticonvulsants are associated with severe disease. The patients with proper wound care and treatment with immunosuppressive drugs can be recovered without or with minimal sequelae. (Turk Pediatri Ars 2016; 51: 152-8)

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Section: Discussionmentioning

confidence: 99%

Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience

2016

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“…According to Ferrandiz-Pulido [14,20], late complications occur in approximately 29% of cases and include skin discolouration, nail deformities, chronic ulcerations of the oral cavity and sexual organs, lingual papilla atrophy, photophobia, dry conjunctivitis, conjunctival adhesions, impaired growth of lashes, and blindness. Finkelstein [15] assessed the incidence of late complications at 47%. In the majority of cases, skin discolouration and scars (42%) as well as various types of vision impairment (27%) are observed; the remaining ones include phimosis, bronchitis, cholangitis and venous thrombosis.…”

Section: Treatmentmentioning

confidence: 99%

“…Similar mortality rates in the paediatric population were observed in studies based on case series. According to Spies and colleagues [13] and Ferrandiz-Pulido and colleagues (14), the mortality was 7%; Finkelstein and co-workers [15] found it to be even lower, i.e., 2%.…”

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confidence: 97%

Zespół toksycznej nekrolizy naskórka

Hinc-Kasprzyk¹,

Polak-Krzemińska²,

Ożóg-Zabolska³

2015

Anaesthesiol Intensive Ther

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, are rare, life-threatening diseases that are characterised by extensive epidermal detachment, erosion of mucous membranes and severe systemic symptoms. In the majority of cases, the development of symptoms can be attributed to the use of drugs; therefore, the disease pathology is thought to be caused by a severe adverse reaction to drugs. The high mortality rate results primarily from the development of complications in the form of systemic infections and multiple organ failure. TEN and SJS affect all age groups, including newborns, infants and older children. The rarity of these syndromes has not permitted large, randomised studies, which has resulted in numerous difficulties in their diagnosis and management. Because the pathogenesis has not yet been established, the management and systemic treatment of these syndromes have not been standardised. The efficacy of the treatment options suggested has not been confirmed by clinical studies involving suitably large groups of patients, especially children.

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“…С ССД наиболее часто ассоциируется прием лекарственных препаратов -антиконвульсантов, сульфаниламидов, антибактериальных, нестероид ных противовоспалительных препаратов. В лите ратуре есть указания на возможную связь ССД с ми коплазменной инфекцией, вирусом простого герпеса [4,5]. Y.…”

Section: заметки из практикиunclassified

“…Отдаленные последствия касаются прежде всего по ражения кожи и глаз. Лишь у 1 (2 %) больного сфор мировался облитерирующий бронхиолит [5]. Заин тересованность дистальных отделов респираторного тракта всегда ассоциируется с неблагоприятным прогнозом.…”

Section: заметки из практикиunclassified

Severe broncho6bronchiolitis obliterans associated with Stevens–Johnson syndrome

Asherova¹,

Popov²,

Мягкова³

et al. 2015

Pulʹmonologiâ (Mosk.)

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Заметки из практикиСиндром Стивенса-Джонсона (ССД) или токсичес кий эпидермальный некролиз (ТЭН) представляет собой редкое, тяжелое, жизнеугрожающее заболе вание, характеризующееся отслойкой эпидермиса и поражением слизистых оболочек [1,2]. Ранее счи талось, что ССД / ТЭН -тяжелейшее проявление лекарственной аллергии. В то же время помимо ме дикаментозных, этиологическими факторами могут являться инфекция, вакцинация, системные заболе вания.ССД впервые описан в 1922 г. Проявления ТЭН впервые представлены в работе A.Lyell (1956) [3], в связи с этим заболевание получило название синд рома Лайелла. В настоящее время ССД и ТЭН рас сматриваются как разные по тяжести варианты еди ного патологического процесса и объединены термином ССД / ТЭН [1,2]. При ТЭН как более тя желом проявлении заболевания отслойка эпидерми са составляет > 30 % поверхности тела. Летальность при ССД составляет 1-5 %, при ТЭН -10-40 %. Манифестация клинических проявлений ССД / ТЭН сопровождается фебрильной лихорадкой в сочета нии с эритематозными пятнами и мишеневидными элементами с последующей отслойкой эпидермиса (симптом Никольского) [1][2][3]. В процесс вовлека ются слизистые оболочки полости рта, глаз, уроге нитального тракта.Патогенез ССД / ТЭН не совсем ясен, хотя хоро шо известно, что поражение эпидермиса и слизис тых оболочек является результатом массивного апоптоза. Нередко заболевание сопровождается вис церальными повреждениями, включая легочные ос ложнения, гепатиты, гломерулонефриты, желудоч но кишечные кровотечения. В случае поражения SummaryPulmonary complications in Stevens Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are rare and mostly manifest as broncho bron chiolitis obliterans with poor prognosis. Recently, there is no effective therapy for this condition in patients with SJS / TEN. We described a case of SJS with progressive hypercapnic respiratory failure in 4.5 year boy who died despite an intensive treatment. Therefore, lung transplantation should be considered at the early stage of this disease.

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Recurrence and Outcomes of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Children

Cited by 147 publications

References 28 publications

Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience

Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience

Zespół toksycznej nekrolizy naskórka

Severe broncho6bronchiolitis obliterans associated with Stevens–Johnson syndrome

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