Metabolic predisposition to cutaneous adverse drug reactions. Role in toxic epidermal necrolysis caused by sulfonamides and anticonvulsants

1995 ◽  
Vol 131 (5) ◽  
pp. 544-551 ◽  
Author(s):  
P. Wolkenstein
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Drug Reactions

scholarly journals Nimesulide induced toxic epidermal necrolysis: a rare case report

2017 ◽  
Vol 6 (12) ◽  
pp. 2939
Author(s):  
Vineet Kumar ◽  
Manju Gari ◽  
Kishor Chakraborty ◽  
Ravi Ranjan ◽  
Anshuman Chandra ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Over The Counter ◽  
Medical Practitioners ◽  
Rare Case Report ◽  
Prescribed Medicines ◽  
Anti Fungal ◽  
Possible Cause ◽  
Antipyretic Action

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Nimesulide, a selective cyclo-oxygenase (COX-2) inhibitor was first launched in Italy in 1985 and subsequently marketed in more than 50 countries including India. Due to its better and faster antipyretic action, it has gained popularity among physicians and paediatricians. Here, we report a case of 60 years old male patient who developed toxic epidermal necrolysis (TEN) following ingestion of tablet nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, anti-fungal and supportive care. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN. Nimesulide has never been approved in countries like USA, Canada, Britain, New Zealand, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and medical practitioners should report all the adverse drug reactions to such drugs. 

Cutaneous Adverse Drug Reactions

2018 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Patch testing in severe cutaneous adverse drug reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis

1996 ◽  
Vol 35 (4) ◽  
pp. 234-236 ◽  
Author(s):  
Pierre Wolkenstein ◽  
Oliver Chosidow ◽  
Marie-Laure Fléchet ◽  
Odile Robbiola ◽  
Muriel Paul ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Patch Testing ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Johnson Syndrome

Cutaneous Adverse Drug Reactions

2012 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Neutrophils initiate and exacerbate Stevens-Johnson syndrome and toxic epidermal necrolysis

2021 ◽  
Vol 13 (600) ◽  
pp. eaax2398
Author(s):  
Manao Kinoshita ◽  
Youichi Ogawa ◽  
Natsumi Hama ◽  
Inkin Ujiie ◽  
Akito Hasegawa ◽  
...  
Keyword(s):  
T Cells ◽  
Immune Responses ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Cytotoxic T Cells ◽  
Formyl Peptide Receptor ◽  
Stevens Johnson Syndrome ◽  
Lipocalin 2 ◽  
Drug Reactions ◽  
Johnson Syndrome

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous adverse drug reactions characterized by massive epidermal detachment. Cytotoxic T cells and associated effector molecules are known to drive SJS/TEN pathophysiology, but the contribution of innate immune responses is not well understood. We describe a mechanism by which neutrophils triggered inflammation during early phases of SJS/TEN. Skin-infiltrating CD8+ T cells produced lipocalin-2 in a drug-specific manner, which triggered the formation of neutrophil extracellular traps (NETs) in early lesional skin. Neutrophils undergoing NETosis released LL-37, an antimicrobial peptide, which induced formyl peptide receptor 1 (FPR1) expression by keratinocytes. FPR1 expression caused keratinocytes to be vulnerable to necroptosis that caused further release of LL-37 by necroptotic keratinocytes and induced FPR1 expression on surrounding keratinocytes, which likely amplified the necroptotic response. The NETs-necroptosis axis was not observed in less severe cutaneous adverse drug reactions, autoimmune diseases, or neutrophil-associated disorders, suggesting that this was a process specific to SJS/TEN. Initiation and progression of SJS/TEN keratinocyte necroptosis appear to involve a cascade of events mediated by innate and adaptive immune responses, and understanding these responses may contribute to the identification of diagnostic markers or therapeutic targets for these adverse drug reactions.

Seizure and Toxic Epidermal Necrolysis with Fluoroquinolone; Another Case of TEN with Levofloxacin; Neurotoxicity with Unexpected High Levels of Free Valproic Acid; Acute Clonidine Withdrawal Leads to an Acute Myocardial Infarction; Hepatotoxicity and Hepatorenal Toxicity with SSRIs; Serotonin Toxicity Associated with Linezolid; The RADAR Project – Research on Adverse Drug Events and Reports; Nonadherence Causes Problems!

2005 ◽  
Vol 40 (8) ◽  
pp. 650-657 ◽  
Author(s):  
Joel Shuster
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Valproic Acid ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Adverse Drug Events ◽  
Drug Reactions ◽  
Clonidine Withdrawal ◽  
Serotonin Toxicity

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.

Adverse Drug Reactions: Drug-Induced Toxic Epidermal Necrolysis

1994 ◽  
Vol 7 (2) ◽  
pp. vi-viii
Author(s):  
Debra J. Olsen ◽  
Julienne K. Kirk ◽  
Patricia Flores-Runk
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Drug Induced

scholarly journals A rare case of oxcarbazepine induced Stevens Johnson Syndrome: toxic epidermal necrosis overlap

2017 ◽  
Vol 6 (2) ◽  
pp. 466
Author(s):  
Aditi Maitra ◽  
Shashwat Bhattacharyya ◽  
Shatavisa Mukherjee ◽  
Nikhil Era
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Rare Case ◽  
Stevens Johnson Syndrome ◽  
Toxicity Profile ◽  
Drug Reactions ◽  
Clinical Safety ◽  
Drug Eruptions ◽  
Johnson Syndrome ◽  
Epidermal Necrosis

Oxcarbazepine is a closely related analogue of carbamazepine and is useful in the monotherapy of seizures with an improved toxicity profile. Its clinical safety has been recently put under scrutiny as evidence has emerged about its adverse drug reactions and it is increasingly being reported to cause cutaneous drug eruptions. Here we report a rare case of oxcarbazepine induced Stevens Johnson - toxic epidermal necrolysis overlap.

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