Toxic epidermal necrolysis: an update

Tiwari, Prashant; Panik, Rajnikant; Bhattacharya, Arin; Ahirwar, Dheeraj; Chandy, Anish

doi:10.1016/s2222-1808(13)60051-1

Cited by 7 publications

(11 citation statements)

References 54 publications

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“…TEN is a potentially life-threatening dermatologic disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis and/or death (7). The average reported mortality of TEN is 25-35%; it can be even higher in elderly patients and those with a large surface area of epidermal detachment (8).…”

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

“…The management concentrate on resuscitative and supportive strategies with the primary concern that of avoiding infection. The general measures include immediate withdrawal of all the suspected drugs is the key to the management of TEN (10).…”

Section: Figure 5 a B Histopathological Findings Showing Epidermal mentioning

confidence: 99%

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One case of toxic epidermal necrolysis after treatment with belimumab in a patient with systemic lupus erythematosus

Duna¹,

Balanescu²,

Iosif³

et al. 2019

Ro J Rheumatol.

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Belimumab is a human immunoglobulin G1-lambda-1 (IgG1-λ) monoclonal antibody that targets the soluble BLyS human protein, also known as B-cell activating factor (BAFF) approved for the treatment of systemic lupus erythematosus (SLE). Serious and sometimes fatal infections have been reported in patients receiving novel immunosuppressive agents, including belimumab. Thus, physicians should exercise caution when considering belimumab in patients with SLE. A 50-year-old woman with SLE presented with a severe, diffuse rash two months after initiating treatment with belimumab. A skin biopsy revealed epidermal necrolysis with keratinocyte detachment and apoptosis in the basal layer of the epidermis, suggestive for toxic epidermal necrolysis (TEN). Belimumab was discontinued and 500 mg of pulse IV methylprednisolone therapy every day for 3 days were administered, with resolution of the skin lesions in the following days. To the best of our knowledge, this is the first case of belimumab-associated TEN.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

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One case of toxic epidermal necrolysis after treatment with belimumab in a patient with systemic lupus erythematosus

Duna¹,

Balanescu²,

Iosif³

et al. 2019

Ro J Rheumatol.

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“…SJS which is defined by an involvement of less than 10% of the epidermis, is a rare but potentially fatal form of CADR with a mortality of 5–15% [1, 11, 13]. Though SJS is thought to have varied causes, medications are most commonly implicated [2, 14]. Amongst medications, antimicrobials are most commonly associated with SJS [4].…”

Section: Discussionmentioning

confidence: 99%

Ivermectin induced Steven–Johnsons syndrome: case report

et al. 2017

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BackgroundStevens–Johnson syndrome is one of the manifestations of mucocutaneous adverse drug reactions. Although antimicrobials are responsible for greater than 50% of these adverse drug reactions, there is no documented case implicating ivermectin as the culprit.Case summaryA 38 year old adult Cameroonian male presented to our health facility with facial rash, painful oral sores, black eschars on lips and red tearing eyes 3 days following ingestion of ivermectin received during a nationwide anti-filarial campaign. He had no known chronic illness, no known allergies and was not on any medications prior to the campaign. Physical examination revealed discharging erythematous eyes, crusted and blister-like lesions with cracks on his lips and oral mucosa. His laboratory tests were unremarkable but for a positive Human Immunodeficiency Virus (HIV) test. A diagnosis of Ivermectin induced Stevens–Johnson syndrome in a newly diagnosed HIV patient was made. The patient was managed with supportive therapy and the evolution thereafter was favourable.ConclusionStevens–Johnson syndrome is a potential side effect of ivermectin and susceptibility to this adverse effect may be increased in HIV infection.

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“…In parallel, we combined the antibiotic therapy appropriate to isolated bacteria, avoiding the medication at risk of cross-reactions of hypersensitivity. Intravenous immunoglobulins, plasmapheresis or biological agents (infliximab), cyclophosphamide, cyclosporine, pentoxifylline or N-acetylcysteine, considered as third-line agents in the treatment of TEN [15], were not required.…”

Section: Infection and Drug-induced Toxic Epidermal Necrolysismentioning

confidence: 99%

Infection and drug-induced toxic epidermal necrolysis: A case report

Bîrluțiu¹,

Bîrluţiu²,

Iancu³

2018

biomedicalresearch

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Lyell's syndrome or toxic epidermal necrolysis is a dermatological disease with severe evolution, and cutaneous-mucosal lesions involving more than 30% of body surface area. The following are the most commonly involved in triggering TEN: antibiotics, anti-inflammatory drugs, chemotherapeutic agents, antivirals, and anticonvulsants drugs. The evolution is accompanied by local complications (superinfections, vicious scars), or general complications (sepsis, multiple organ failure). We present the case of a patient with infectious-induced Lyell's syndrome associated with exposure to two classes of drugs at risk of inducing Lyell's syndrome (antibiotics and nonsteroidal anti-inflammatory drugs). Supportive therapy, associated with the treatment of cutaneous mucosal lesions, and the treatment of sepsis, were the most important elements that led to a favourable evolution of our case.

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Toxic epidermal necrolysis: an update

Cited by 7 publications

References 54 publications

One case of toxic epidermal necrolysis after treatment with belimumab in a patient with systemic lupus erythematosus

One case of toxic epidermal necrolysis after treatment with belimumab in a patient with systemic lupus erythematosus

Ivermectin induced Steven–Johnsons syndrome: case report

Infection and drug-induced toxic epidermal necrolysis: A case report

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