Topical Treatment for Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis: A Review

Purnamawati, Schandra; Febriana, Sri Awalia; Danarti, Retno; Saefuddin, Tatan

doi:10.15562/bmj.v5i1.274

Cited by 8 publications

(10 citation statements)

References 34 publications

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“…Both SJS and TEN develop severe cutaneous adverse reactions (SCAR) characterized by erythematous skin lesions and extensive release of erosions or ulcerations of the mucous membrane. 8,9 The parameter that differentiates SJS and TEN is the level of body involvement affected with the lesion known as body surface area (BSA). If the BSA value is less than 10%, the condition is categorized as SJS with a mortality rate of 1-5%.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, there is also a severity assessment score for SJS or TEN called SCORTEN that is inclined to mortality variables. 8,9,12 The pathogenesis of SJS cannot yet be fully understood, but several theories express an immunological process as the cause that provoke such condition in which a hypersensitivity reaction take place. Hypersensitivity reactions are mediated by cytotoxic T lymphocytes and natural killer cells resulting in apoptosis of keratinocytes.…”

Section: Resultsmentioning

confidence: 99%

“…This triggers the release of cytokines (TNF-alpha) which results in more inflammation and eventually leads to necrosis. 2,8,13 Erythema and oral ulceration are the initial complaints of the patient but may not be remarkably concerned. In the literature, early diagnosis of SJS can solely be made based on the presence of lesions in the oral cavity.…”

Section: Resultsmentioning

confidence: 99%

“…Oral mucosal lesions displays hemorrhagic crusts on the lips and multiple ulcers or erosions. [1][2][3]5,8,9 The involvement of oral mucosal lesions causes disruption in speech, mastication, and swallowing function. This will lead to the disturbance in nutrients and fluids intake causing electrolyte imbalances that aggravate dehydration.…”

Section: Introductionmentioning

confidence: 99%

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The Important Role of Oral Medicine Specialist in Management of Stevens-Johnson Syndrome Patient

Fitriasari¹,

Nurtito²,

Nur’aeny³

et al. 2020

Dentino

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Introduction: Stevens-Johnson Syndrome (SJS) is an acute hypersensitivity reaction that manifests on the skin, oral mucosa, ocular, gastrointestinal, genital and anal area. It is also potentially life-threatening in concern of dehydration and infection. Oral mucosal lesions due to SJS resulted in a significant decrease of patient’s quality of life. When the oral mucosa involved, the intake of nutrients and fluids is disrupted contributing to electrolyte imbalance that aggravates dehydration. Moreover, oral mucosal lesions have become an entry point for infection. Purpose: This case report describes the important role of oral medicine specialists in the management of oral mucosal lesions in SJS patient. Review: A 26-year-old female patient was referred from the Department of Dermatology and Venereology with a diagnosis of SJS et causa suspected paracetamol and/or amoxycillin. The complaints comprised of pain on the lips and oral cavity, difficulty in mouth opening, and pain when swallowing. The management for oral lesions included: history taking, external and intra oral examinations, dexamethasone mouthwash, nystatin oral suspension, and sodium chloride (NaCl) 0.9% solution. The patient showed improvement in oral mucosal lesions within 3 weeks of treatment that was provided by oral medicine specialist and medical team collaboration. Conclusion: Based on this case report, the role of oral medicine specialist is very important as part of the management team for SJS patient. Oral medicine specialist can reduce morbidity that results from oral mucosal involvement. Collaboration with oral medicine specialist since the beginning of treatment is the key to success in SJS management. Keywords: Oral medicine specialist, Oral mucosal lesion, Stevens-Johnson Syndrome.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Important Role of Oral Medicine Specialist in Management of Stevens-Johnson Syndrome Patient

Fitriasari¹,

Nurtito²,

Nur’aeny³

et al. 2020

Dentino

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“…[12][13][14][15] SJS merupakan reaksi mukokutan akut, ditandai oleh nekrosis epidermis luas dengan keterlibatan minimal 2 membran mukosa yang dipicu oleh obat, jarang karena infeksi dan keganasan. 16 SLE adalah suatu kondisi inflamasi yang berhubungan dengan gangguan autoimun, sistem tubuh menyerang jaringannya sendiri yang menyebabkan kerusakan multiorgan ditandai dengan 4 dari 11 kriteria seperti ruam malar, ruam diskoid, fotosensitifitas, ulser pada rongga mulut, artritis, serositis, gangguan renal, gangguan neurologi, gangguan hematologi, gangguan imunologis, antibodi antinuclear (ANA). Penyebab spesifik dari SLE masih belum diketahui dengan pasti, diduga banyak faktor predisposisi antara lain faktor genetik, mekanisme imun regulator, hormonal, dan faktor lingkungan.…”

Section: Pendahuluanunclassified

<p>Terapi lesi oral pasien sindrom Stevens-Johnson disertai lupus eritematosus sistemik</p><p>Oral lesion therapy in patients with Stevens-Johnson syndrome with systemic lupus erythematosus</p>

Tamigoes

Dewi

2018

JKG

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ABSTRAKPendahuluan: Adverse drug reaction (ADR) merupakan salah satu respon tubuh manusia tidak diinginkan dan berbahaya yang disebabkan penggunaan obat meskipun dalam dosis normal. ADR dapat menyebabkan terjadinya sindrom Stevens-Johnson (SJS) serta dapat memicu lupus eritematosus sistemik (SLE), yang salah satu manisfestasinya sebagai krusta hemoragik dan erosi yang luas pada mulut dan peri-oral, dapat mengganggu fungsi mulut sehingga terganggunya asupan makanan. Laporan kasus ini bertujuan untuk menjelaskan terapi lesi oral pasien sindrom Stevens-Johnson disertai lupus eritematosus sistemik. Laporan kasus: Seorang pasien wanita berusia 57 tahun dengan riwayat penyakit meningitis tuberkulosis dirujuk ke Bagian Penyakit Mulut dari departemen Ilmu Kesehatan Kulit dan Kelamin dengan diagnosis SJS, pasien mengeluhkan kesulitan untuk membuka mulutnya, sakit menelan dan sakit pada bibir. Terdapat riwayat pemakaian obat ofloxacin, streptomysin, dan OAT. Pemeriksaan ekstraoral menunjukkan beberapa lesi diskret pada wajah, konjungtiva anemis, lesi erosif dan krusta hemoragik pada bibir. Pemeriksaan intraoral ditemukan lesi erosif pada mukosa bukal dan palatal serta plak putih pada dorsal lidah. Pemeriksaan darah rutin menunjukkan hemoglobin, hematokrit, leukosit, MCV, MCH, eosinofil, netrofil, limfosit, protein total dan albumin rendah sedangkan uji ANA positif, sehingga diagnosis ditegakkan sebagai lesi oral terkait SJS disertai SLE dan kandidiasis oral. Medikasi yang diberikan adalah Chlorhexidine gluconate 0,1%, nistatin suspensi oral, vitamin B12, asam folat, dan topikal kortikosteroid. Lesi oral menunjukkan perbaikan dalam waktu 3 minggu, pada pasien terjadi SJS dan SLE secara bersamaan hal ini menunjukkan adanya keterlibatan mekanisme imunologi Simpulan: Terapi non farmakologi berupa pemberian kortikosteroid topikal,obat kumur Chlorhexidine gluconate 0,1%, vitamin B12, asam folat, dan nistatin yang menunjukkan perbaikan pada lesi oral dalam 3 minggu perawatan, ditambah dengan terapi non farmakologi berupa pemeliharaan kebersihan rongga mulut dengan obat kumur Chlorhexidine gluconate 0,1% sebagai antiseptik untuk meningkatkan kenyamanan pasien, untuk memfasilitasi epitelisasi dan mencegah komplikasi seperti infeksi.Kata kunci: Adverse Drug Reaction, lesi oral, sindrom Stevens-Johnson, lupus eritematosus sistemik Oral lesion therapy in patients with Stevens-Johnson syndrome with systemic lupus erythematosus ABSTRACT Introduction: Adverse drug reaction (ADR) is one of the unwanted and dangerous human body responses caused by the use of medications even in regular doses. ADR can cause Stevens-Johnson syndrome (SJS) and trigger systemic lupus erythematosus (SLE), with manifestation such as extensive haemorrhagic and erosive crusts in the mouth and peri-oral, which can interfere the oral function and disrupt the food intake. This case report was aimed to explain the treatment of oral lesions in patients with Stevens-Johnson syndrome with systemic lupus erythematosus. Case report: A 57-years-old female patient with a his...

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Salt and skin

Prarthana

Karthikeyan

2021

Int J Dermatology

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The introduction of salt as a therapeutic agent in dermatological disorders has been in use since ancient times. This ubiquitous agent is the most underrated substance after the advent of modern medicine. Though a commonly used agent in both traditional and modern medicine, it is important to understand its relationship to the skin to further enhance the comprehensive benefit. The complex history of the evolution of medicine and its skewed distribution among the countries of the world led to inclusion of locally available and economical agents into therapeutics as it becomes almost an inevitable need.Moreover, an inadequate knowledge about the harmful effects of chronic salt exposure led salt to have a unique role in occupational dermatoses. There is no adequate literature on both detrimental and therapeutic effects of salt and its relation to skin. Hence, a genuine attempt was made to summarize the known and the lesser known facts of this particular common seasoning agent.

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Topical Treatment for Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis: A Review

Cited by 8 publications

References 34 publications

The Important Role of Oral Medicine Specialist in Management of Stevens-Johnson Syndrome Patient

The Important Role of Oral Medicine Specialist in Management of Stevens-Johnson Syndrome Patient

<p>Terapi lesi oral pasien sindrom Stevens-Johnson disertai lupus eritematosus sistemik</p><p>Oral lesion therapy in patients with Stevens-Johnson syndrome with systemic lupus erythematosus</p>

Salt and skin

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