Unusual oral findings of the toxic epidermal necrolysis in an HIV-infected patient: a case report

Vieira, Vinícius Da Costa; Sarmento, Viviane Almeida; Ribeiro, Patrícia Miranda Leite; Netto, Eduardo Martins; Brites, Carlos; Lins-Kusterer, Liliane

doi:10.1016/j.bjid.2019.08.003

Cited by 5 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Administration of short-term corticosteroids pulse therapy, especially during the initial phase of SJS/TEN, may be beneficial in reducing mortality rates. 10 In this case, after discontinuation of use of suspected drugs and being treated for 11 days with intravenous fluid, corticosteroids, and oral antihistamines, his complaints improved. SJS and TEN are potentially fatal severe cutaneous adverse reactions that affect multiple organs and systems.…”

Section: Discussionmentioning

confidence: 77%

Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Kunti,

Suryana

2024

Int J Res Med Sci

View full text Add to dashboard Cite

Co-trimoxazole is a sulfonamide fixed dose combination antibiotic which is effective and widely use in treatment and prevention of opportunistic infections in people living with HIV/AIDS, but can be potentially associated with adverse drug reactions including drug hypersensitivity reactions such as Steven Johnson syndrome. PLWHA individuals have up to a 1000-fold increased risk of drug hypersensitivity reaction compared to the general population, which is associated with drug exposure, immune dysregulation, and concurrent infections. Here we present a case report of a 59-year-old man with HIV who experienced Stevens-Johnson Syndrome after taking co-trimoxazole for 18 days. Therefore, we would like to remind you to be more careful when giving cotrimoxazole to PLWHA because it can take time for a hypersensitivity reaction to occur, also in a few cases, it can occur immediately.

show abstract

Section: Discussionmentioning

confidence: 77%

Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Kunti,

Suryana

2024

Int J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…SSJ dan NET juga dapat memiliki gambaran lesi kulit berupa lesi target yang atipikal. Lesi target atipikal ini yang akan menjadi lesi yang membedakan SSJ dengan Eritema Multiforme (Viera, VDC;Sarmento, VA;Ribeiro, PML;Netto, EM;Brites, C;Lins-Kusterer, 2019). Keterlibatan mukosa pada pasien SSJ dan NET terjadi pada lebih dari 90% kasus.…”

Section: Hasil Dan Pembahasanunclassified

Sindrom Stevens Johnson pada Pasien dengan HIV Reaktif

Novriana,

Mochtar

2024

SLJIL

View full text Add to dashboard Cite

Sindrom Stevens-Johnson (SSJ) dan Nekrolisis Epidermal Toksik (NET) adalah hipersensitivitas akibat obat yang bersifat akut dan dapat mengancam nyawa. Infeksi HIV/AIDS merupakan faktor predisposisi terjadinya SSJ dan NET. Terapi SSJ dan NET bersifat suportif dan simtomatik. Studi ini bertujuan untuk memberikan gambaran tentang tatalaksana SSJ dan NET pada seorang pasien dengan infeksi HIV/AIDS. Metode penelitian menggunakan studi kasus terhadap seorang wanita usia 29 tahun dengan infeksi HIV/AIDS yang mengalami SSJ dan NET setelah mengonsumsi ARV. Pasien telah terdiagnosa dengan infeksi HIV dan telah mengonsumsi ARV yaitu nevirapin, lamivudin dan zidovudin sejak Oktober 2019. Hasil pemeriksaan fisik pasien ini didapatkan bula yang telah pecah, krusta hemoragik, erosi dan pelepasan epidermis. Tatalaksana pada pasien ini yaitu metilprednisolon intravena 62.5mg/24jam kemudian di tapering off, medikasi dengan kompres NaCl 0.9% selama 10-15 menit kemudian oles salep triamsinolon asetonida 0.1% pada area erosi di mukosa bibir diberikan 2x sehari dan gentamisin salep pada area erosi di tubuh 2x sehari. Sindrom Stevens-Johnson dan Nekrolisis Epidermal Toksik ditandai dengan adanya makula pupurik, bula, lesi target atipikal dan pelepasan epidermis. Obat yang diketahui sering menyebabkan SSJ dan NET pada pasien dengan infeksi HIV/AIDS adalah nevirapin. Pasien dengan infeksi HIV/AIDS memiliki kerentanan yang lebih tinggi untuk mengalami SSJ dan NET. Kortikosteroid sistemik, imunoglobulin intravena dan terapi imunosupresif lainnya dapat digunakan untuk kasus ini. Sindrom Stevens-Johnson merupakan hipersensitivitas akibat obat yang sering terjadi pada infeksi HIV/AIDS. Kondisi ini dapat disebabkan oleh ARV seperti nevirapin.

show abstract

“… 5 – 7 However, TEN cases caused by antituberculosis agents were mostly reported in patients with immunosuppressant treatment, such as in HIV or SLE patients. 7 – 9 The timeline from presenting TEN symptoms to hospital admission usually varies from 4-15 days. 7 , 8 Here we report an immunocompetent patient with delayed TEN 30 days after antituberculosis therapy.…”

Section: Introductionmentioning

confidence: 99%

Case Report: A successful case of toxic epidermal necrolysis treated with plasmapheresis therapy

et al. 2022

View full text Add to dashboard Cite

Toxic epidermal necrosis (TEN) is rare and can be life-threatening for patients. Appropriate management of TEN patients could give optimal results and prevent complications. One treatment modality for TEN is plasmapheresis, which is rarely available in most cases with severe TEN. Here we reported a successful treatment of severe TEN with plasmapheresis. A 40-year-old woman under tuberculosis therapy complained of shortness of breath that began four days prior to hospital admission and worsened ever since. The patient's skin was peeling with red spots and rashes all over the body for a week. During the examination, the patient was compos mentis, and the SCORTEN score was 2 with 12.1% risk of mortality rate. Dermatological examination of the face, trunk and extremities found extensive erosions, loose bullae filled with clear fluid, brown crusts, and generalized distribution with more than 30% epidermolysis. The patient was diagnosed with toxic epidermal necrolysis caused by antituberculosis therapy. We treated the patient by discontinuing the suspected drugs and administering the corticosteroids, but no improvement was observed. The patient underwent two cycle plasmaphereses with 5% albumin, resulting in 1.2 liter of plasma exchange. Re-epithelialization was observed after three days, and the patient was discharged on day 8. This case-report highlights the important role of plasmapheresis in treating the TEN patients. However, a study with larger sample sizes is warranted to validate the efficacy of plasmapheresis in TEN.

show abstract

Unusual oral findings of the toxic epidermal necrolysis in an HIV-infected patient: a case report

Cited by 5 publications

References 19 publications

Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Sindrom Stevens Johnson pada Pasien dengan HIV Reaktif

Case Report: A successful case of toxic epidermal necrolysis treated with plasmapheresis therapy

Contact Info

Product

Resources

About