Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

Medicina, Год журнала: 2021, Номер 57(9), С. 895 - 895

Опубликована: Авг. 28, 2021

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that characterized by widespread epidermal necrosis sloughing of skin. They associated with significant morbidity mortality, early diagnosis treatment is critical in achieving favorable outcomes for patients. In this scoping review, Excerpta Medica dataBASE PubMed were searched publications addressed recent advances the management disease. Multiple proteins (galectin 7 RIP3) identified promising potential biomarkers SJS/TEN, although both still phases research. Regarding treatment, cyclosporine most effective therapy SJS, a combination intravenous immunoglobulin (IVIg) corticosteroids SJS/TEN overlap TEN. Due to nature disease, there lack prospective, randomized controlled trials conducting these future would provide valuable insights into

Язык: Английский

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Clinical features, treatment, and prognosis of pembrolizumab -induced Stevens-Johnson syndrome / toxic epidermal necrolysis

Investigational New Drugs, Год журнала: 2025, Номер unknown

Опубликована: Янв. 3, 2025

Язык: Английский

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Liver Injury in Immune Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Five New Classification Types

Journal of Clinical and Translational Hepatology, Год журнала: 2025, Номер 000(000), С. 000 - 000

Опубликована: Янв. 17, 2025

Liver injury in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is a multifaceted disorder, lacking cohort homogeneity due to variety of potential causes, including drugs, arsenic other heavy metals, glyphosate, infections, ultraviolet radiation. The goals this review were (1) analyze the role diagnostic algorithms assessing causality for culprits involved development liver associated with immune-mediated SJS TEN, which represent immune-based variant disorders within continuous spectrum. Milder forms are classified as or SJS/TEN overlap, while TEN known most serious form; (2) interpret findings that allow characterization different types these disorders. manuscript based on an extensive literature search single case reports, cohorts, articles. Search terms included: Syndrome, Toxic Epidermal Necrolysis, specific such Roussel Uclaf Causality Assessment Method (RUCAM) Algorithm Drug Necrolysis (ALDEN). For purpose basic feature description, uniform term used current analysis. presents five types: type (1), refers caused by assessed both ALDEN RUCAM; (2), representing drugs only, but not (3), includes non-ALDEN non-RUCAM tools; (4), focuses non-drug culprits, various (5), considers unknown culprits. Using new typology will help better characterize individual features, personalize treatment, clarify pathogenetic specifics each disease types. This provides clarity replacing issues inhomogeneity homogeneity.

Язык: Английский

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Camrelizumab-induced immune-related toxic epidermal necrolysis in lung adenocarcinoma: a case report and literature review

Frontiers in Oncology, Год журнала: 2025, Номер 14

Опубликована: Янв. 13, 2025

Toxic epidermal necrolysis (TEN) is a rare and serious skin reaction. This study reports case of patient with lung adenocarcinoma (LUAD) who developed severe TEN after 8 days treatment Camrelizumab monotherapy. The patient’s condition was effectively relieved high-dose corticosteroids intravenous immunoglobulin therapy. diagnosis immune-related are challenging. associated the use Camrelizumab. Additionally, we provide an in-depth understanding TEN, summarizing its characteristics progress through literature review, aiming to reference for clinical safe application immune checkpoint inhibitors (ICIs).

Язык: Английский

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Thiotepa-Induced Toxicity: A Clinical Mimic of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis Featuring Severe Mucositis, Diffuse Dusky Discoloration, and Skin Sloughing

American Journal of Dermatopathology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 6, 2025

Background: Thiotepa, an alkylating agent commonly used in chemotherapy, is increasingly recognized to induce cutaneous reactions resembling toxic erythema of chemotherapy (TEC). This condition characterized by erythema, hyperpigmentation, and mucositis, often affecting intertriginous areas, can mimic the early stages Stevens–Johnson syndrome (SJS) or epidermal necrolysis (TEN). Case description: A 31-year-old woman with a history systemic lupus erythematosus, antiphospholipid antibody syndrome, seizures, chronic kidney disease was admitted for management central nervous system (CNS) lymphoma. Seven days after receiving thiotepa during autologous stem cell transplant, she developed severe requiring intubation airway protection, followed dusky, gray, full-body rash sloughing groin, axillae, buttocks. skin biopsy from back revealed vacuolar interface changes, eccrine gland necrosis, occasional necrotic keratinocytes at dermal-epidermal junction, no evidence full-thickness necrosis significant eosinophilic infiltration. The differential diagnosis included thiotepa-induced toxicity, SJS/TEN, drug eruption. Based on patient's clinical presentation findings, TEC favored over SJS/TEN. Discussion: Thiotepa potent lipophilic widely pediatric adult patients various solid tumors hematologic malignancies. Its anticancer mechanism involves DNA alkylation, leading strand cross-linking that disrupts replication transcription, ultimately inhibiting cancer proliferation survival. While primarily utilized high-dose preparative regimens transplantation patients, its use population remains comparatively limited. case emphasizes importance differentiating adverse such as these conditions share histologic features, absence extensive satellite involvement, along recent exposure, supported TEC. Conclusions: highlights diagnostic challenge distinguishing SJS/TEN post-transplant patients. Recognizing characteristic involvement areas critical accurate management. Awareness this potential complication essential avoid misdiagnosis inappropriate treatment.

Язык: Английский

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Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review of PubMed/MEDLINE case reports from 1980 to 2020

Frontiers in Medicine, Год журнала: 2022, Номер 9

Опубликована: Авг. 24, 2022

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life-threatening immunologic reactions. Prior studies using electronic health records, registries or reporting databases often limited in sample size lack clinical details. We reviewed diverse detailed case reports published over four decades.Stevens-Johnson necrolysis-related were identified from the MEDLINE database between 1980 2020. Each report was classified by severity (i.e., SJS, TEN, SJS-TEN overlap) after being considered a "probable" "definite" SJS/TEN case. The demographics, preconditions, culprit agents, course, mortality of cases analyzed across disease severity.Among 1,059 cases, there 381 (36.0%) 602 (56.8%) 76 (7.2%) overlap with rate 6.3%, 24.4%, 21.1%, respectively. Over one-third had immunocompromised conditions preceding onset, including cancer (n = 194,18.3%), autoimmune diseases 97, 9.2%), human immunodeficiency virus (HIV) 52, 4.9%). During acute phase reaction, 843 (79.5%) reported mucous membrane involvement 210 (19.8%) involved visceral organs. Most drug-induced 957, 90.3%). A total 379 drug culprits reported; most frequently antibiotics 285, 26.9%), followed anticonvulsants 196, 18.5%), analgesics/anesthetics 126, 11.9%), antineoplastics 120, 11.3%). 127 (12.0%) non-drug culprits, infections 68, 6.4%), which 44 associated mycoplasma pneumoniae infection radiotherapy 27, 2.5%).An expansive list potential causative agents large set literature-reported warrant future investigation to understand risk factors manifestations different populations.

Язык: Английский

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Updates in SJS/TEN: collaboration, innovation, and community

Frontiers in Medicine, Год журнала: 2023, Номер 10

Опубликована: Окт. 11, 2023

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) is a predominantly drug-induced disease, with mortality rate of 15–20%, that engages the expertise multiple disciplines: dermatology, allergy, immunology, clinical pharmacology, burn surgery, ophthalmology, urogynecology, and psychiatry. SJS/TEN has an incidence 1–5/million persons per year in United States, even higher rates globally. One challenges been developing research infrastructure coordination to answer questions capable transforming care leading improved patient outcomes. 2021, third meeting its kind, was held as virtual on August 28–29, 2021. The brought together 428 international scientists, addition community 140 survivors family members. goal brainstorm strategies support continued growth network, bridging science community. workshop section focused eight primary themes: mental health, eye care, children, non-drug induced SJS/TEN, long-term health complications, new advances mechanisms basic science, managing scarring, considerations for skin color, COVID-19 vaccines. featured several important updates identified areas unmet need will be highlighted this white paper.

Язык: Английский

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Aqueous-deficient dry eye disease: Preferred practice pattern guidelines on clinical approach, diagnosis, and management

Indian Journal of Ophthalmology, Год журнала: 2023, Номер 71(4), С. 1332 - 1347

Опубликована: Апрель 1, 2023

Dry eye disease (DED) is a broad term that includes diverse group of clinical disorders. Aqueous-deficient dry (ADDE), subtype DED, characterized by decreased tear production the lacrimal gland. It can be seen in up to one-third individuals with DED and comorbid systemic autoimmune process or occur secondary an environmental insult. Since ADDE source long-term suffering severe visual impairment, early identification adequate treatment are imperative. Multiple etiologies underlie ADDE, it critical identify underlying cause not only improve ocular health but also overall quality life well-being affected individuals. This review discusses various highlights pathophysiology-based approach for evaluating contributors, outlines diagnostic tests, reviews options. We present current standards discuss ongoing research this field. Through review, we propose algorithm would useful ophthalmologist diagnosing managing ADDE.

Язык: Английский

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The Preparation and Clinical Efficacy of Amnion-Derived Membranes: A Review

Journal of Functional Biomaterials, Год журнала: 2023, Номер 14(10), С. 531 - 531

Опубликована: Окт. 20, 2023

Biological tissues from various anatomical sources have been utilized for tissue transplantation and developed into an important source of extracellular scaffolding material regenerative medicine applications. Tissue scaffolds ideally integrate with host provide a homeostatic environment cellular infiltration, growth, differentiation, resolution. The human amniotic membrane is considered due to its 3D structural architecture function as growth factors cytokines. This has widely studied used in areas repair including intraoral reconstruction, corneal repair, tendon microvascular nerve procedures, burns, chronic wound treatment. production allografts not standardized, resulting wide array products, single, dual, tri-layered such amnion, chorion, amnion-chorion, amnion-amnion, amnion-chorion-amnion allografts. Since these are processed using the same methods, they do necessarily produce clinical responses. aim this review highlight properties different allograft membranes, present processing preservation discuss their use engineering

Язык: Английский

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Overlapping of DRESS and Stevens-Johnson syndrome due to first-line antituberculosis drugs: a case report

Therapeutic Advances in Drug Safety, Год журнала: 2025, Номер 16

Опубликована: Янв. 1, 2025

The overlap of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Stevens-Johnson syndrome (SJS) caused by antituberculosis drugs represents an extremely rare event. This situation can manifest between 2 8 weeks after the first exposure to medication. these conditions lead atypical clinical manifestations, thus complicating early diagnosis implementation treatment. report describes case a patient who developed DRESS/SJS 35 days starting experienced severe skin systemic involvement, that required her admission monitoring in intensive care unit. From our experience this case, we conclude importance accurate timely using validated scoring systems such as RegiSCAR confirm ALDEN assess likelihood drug causality. Timely intervention corticosteroids plays key role moderating exaggerated immune response, helping alleviate dermatological symptoms prevent long-term organ damage. In addition, availability safe therapeutic alternatives for tuberculosis treatment allows more effective safer management patients.

Язык: Английский

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