Toxic epidermal necrolysis

Pereira, Frederick A.; Mudgil, Adarsh V.; Rosmarin, David

doi:10.1016/j.jaad.2006.04.048

Cited by 287 publications

(256 citation statements)

References 203 publications

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“…In our patients with drug-induced SJS, the mean interval between drug administration and onset of cutaneous findings was 15.3 days. Previous reports in the medical literature describe similar intervals, with the greatest risk of development of SJS occurring in the first 2 months of drug treatment 1 and an interval of 4 to 28 days being the most suggestive of drug causality in SJS. 13 We found that antibiotics and anticonvulsants were the most common medications causing SJS, with trimethoprim-sulfamethoxazole and phenytoin the most common culprits in each drug class, respectively.…”

Section: Discussionsupporting

confidence: 53%

“…This finding is concordant with the emphasis in the medical literature on SJS as a disease that occurs predominantly in younger patients. 1,11 In addition to delineating SJS as a distinct entity from EM major by the clinical pattern of cutaneous lesions, For personal use. Mass reproduce only with permission from Mayo Clinic Proceedings a .…”

Section: Discussionmentioning

confidence: 99%

Section: Dermal Infiltrate Epidermal Infiltratementioning

confidence: 99%

“…1 Some investigators say that corticosteroids may promote infectious complications and lead to a poorer prognosis. 1 However, recently published data from the EuroSCAR study do not reflect an increased mortality in patients treated with corticosteroids but rather a possible beneficial effect that deserves further exploration. 26 Of note, sepsis developed in none of the 15 of our 27 patients who received treatment with corticosteroids for SJS, although 1 patient treated with corticosteroids and intravenous immunoglobulin had a prolonged hospital stay and experienced For personal use.…”

Section: Dermal Infiltrate Epidermal Infiltratementioning

confidence: 99%

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Clinical, Etiologic, and Histopathologic Features of Stevens-Johnson Syndrome During an 8-Year Period at Mayo Clinic

Wetter

Camilleri

2010

Mayo Clinic Proceedings

124

104

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Dermal Infiltrate Epidermal Infiltratementioning

confidence: 99%

Section: Dermal Infiltrate Epidermal Infiltratementioning

confidence: 99%

See 2 more Smart Citations

Clinical, Etiologic, and Histopathologic Features of Stevens-Johnson Syndrome During an 8-Year Period at Mayo Clinic

Wetter

Camilleri

2010

Mayo Clinic Proceedings

124

104

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“…TEN is defined by formation of bullae and skin sloughing, with purpuric spots covering ≥30% of the body surface area, or skin sloughing and bullae alone, involving 10% of the body surface area. The skin manifestations are associated with a marked systemic inflammatory response syndrome and major electrolyte disturbances, with a mortality rate of >30% (1). TEN is classically medication-induced.…”

Section: Introductionmentioning

confidence: 99%

Skin rash in the intensive care unit: Stevens-Johnson syndrome, toxic epidermal necrolysis, or a rare manifestation of a hidden cutaneous malignancy: A case report

Al‐Saffar

Ibrahim

Patel

et al. 2015

Molecular and Clinical Oncology

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Abstract. Skin rashes are infrequently encountered in the intensive care units, either as a result or as a cause of admission. The entities of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) form a spectrum of desquamating skin diseases that have multiple etiologies, the most common being drug-related reactions; very rarely, the cause may be cutaneous malignancies. We herein present a unique case of a 54-year-old male patient with psoriasis treated with methotrexate, who presented with a cellulitis-like clinical picture, then developed a severe progressive systemic inflammatory response syndrome, and progressed clinically to SJS, then TEN even after discontinuing the antibiotics and methotrexate. A skin biopsy demonstrated an aggressive and rapidly-progressing T-cell lymphoma. The present case highlights the necessity of skin biopsy when encountering SJS and TEN in the ICU in order to identify potentially treatable/controllable causes. Although it appeared reasonable to correlate TEN solely to medications, the skin biopsies clearly demonstrated an aggressive T-cell skin lymphoma. In a patient with a better general condition it may have been helpful to treat this malignancy. TEN is a life-threatening condition and skin biopsy is the cornerstone of diagnosis, despite the presence of multiple risk factors and the typical physical findings of a drug-induced reaction.

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