Stevens-Johnson syndrome and toxic epidermal necrolysis

Eginli, Ariana; Shah, Kena; Watkins, Casey; Krishnaswamy, Guha

doi:10.1016/j.anai.2016.11.019

Cited by 11 publications

(13 citation statements)

References 17 publications

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“…Stevens-Johnson syndrome, toxic epidermal necrolysis, and Stevens-Johnson syndrome-toxic epidermal necrolysis overlap are considered variants in a spectrum of disease severity. Stevens-Johnson syndrome involves epidermal detachment of less than 10% of total body surface area, toxic epidermal necrolysis involves epidermal detachment of more than 30% of total body surface area, and Stevens-Johnson syndrome-toxic epidermal necrolysis overlap involves epidermal detachment of 10% to 29% of total body surface area [1].…”

Section: Discussionmentioning

confidence: 99%

“…Stevens-Johnson syndrome and toxic epidermal necrolysis are rare diseases that cause acute destruction of the epithelium of the skin and mucous membrane by a violent immune response [1]. The national incidence per 100,000 was 6.3 for Stevens-Johnson syndrome, 0.7 for Stevens-Johnson syndrome/toxic epidermal necrolysis overlap syndrome, and 0.5 for toxic epidermal necrolysis [2].…”

Section: Introductionmentioning

confidence: 99%

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Stevens-Johnson Syndrome: A Perplexing Diagnosis

Dutt¹,

Sapra²,

Sheth-Dutt³

et al. 2020

Cureus

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Stevens-Johnson syndrome/toxic epidermal necrolysis is a spectrum of mucocutaneous reactions that can occur due to drug reactions, infections with Mycoplasma pneumonia, human immunodeficiency virus (HIV), cancer, and genetics. Stevens-Johnson syndrome involves less than 10% of the body surface, while toxic epidermal necrolysis involves greater than 30%. The most common site of the lesions is mucocutaneous surfaces such as the eyes and oral cavity. Our patient was a 44-year-old female who presented to the emergency department with concerns for pain in her eyes, hands and feet, rash, and sore throat. Her rash worsened during the initial hospitalization. This case emphasizes the importance of pattern recognition of Stevens-Johnson syndrome, as this is a rare but serious condition that must be recognized and treated appropriately. The reaction is most commonly due to medications; however, a thorough history and physical exam are vital to diagnosing this potentially fatal condition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stevens-Johnson Syndrome: A Perplexing Diagnosis

Dutt¹,

Sapra²,

Sheth-Dutt³

et al. 2020

Cureus

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“…SJS/TEN are severe cutaneous adverse reactions characterised by varying degrees of epidermal detachment and erosion of the mucous membranes. Medications are the most commonly reported causes of SJS/TEN, with sulphonamides, carbamazepine, non-steroidal anti-inflammatory drugs, allopurinol, phenytoin and phenobarbital being the most common culprit agents 4. SJS/TEN typically occurs 4–21 days after starting use of the offending drug.…”

Section: Discussionmentioning

confidence: 99%

Stevens-Johnson syndrome/toxic epidermal necrolysis: treatment with low-dose corticosteroids, vitamin C and thiamine

et al. 2019

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We present the case of a 33-year-old woman with no significant past medical history who was admitted to an outside hospital for the abrupt onset of fevers, malaise and a diffuse mucocutaneous rash. Her constellation of symptoms and presentation were most consistent with a diagnosis of Stevens-Johnson syndrome/toxic epidermal necrolysis overlap syndrome secondary to ibuprofen exposure. Her rash continued to worsen and she was transferred to our medical intensive care unit (ICU), where broad-spectrum antibiotics were discontinued and she was treated with supportive care as well as ‘low-dose’ intravenous hydrocortisone, ascorbic acid (vitamin C) and thiamine (HAT therapy). After starting this therapy, the patient demonstrated a dramatic response with rapid improvement of her cutaneous and mucosal lesions. She was tolerating a diet provided by the hospital on day 4 and was discharged from the ICU a few days later.

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“…The acute prodromal phase of the disease lasts 1 to 4 days, during which patients may experience fever, malaise, cough, rhinorrhoea, photophobia, and diffuse erythema. 7 Then, patients begin to develop mucosal and cutaneous lesions that are easily denuded with lateral shearing pressure applied by a clinician. [7][8] A 20-year study performed in a tertiary referral hospital of Thailand reviewed all children diagnosed with SJS/TEN/SJS-TEN overlap and 12/36 cases had TEN (33.3%).…”

Section: Discussionmentioning

confidence: 99%

“…7 Then, patients begin to develop mucosal and cutaneous lesions that are easily denuded with lateral shearing pressure applied by a clinician. [7][8] A 20-year study performed in a tertiary referral hospital of Thailand reviewed all children diagnosed with SJS/TEN/SJS-TEN overlap and 12/36 cases had TEN (33.3%). The patients presented with morbilliform rash (83.3%), blisters (38.9%), targetoid lesions (25.0%), and purpuric macules (2.8%), and the most common mucosal involvements were oral (97.2%) and eye mucosae (83.3%).…”

Section: Discussionmentioning

confidence: 99%