scholarly journals The Epidemiology of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in China

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Shang-Chen Yang ◽  
Sindy Hu ◽  
Sheng-Zheng Zhang ◽  
Jin-wen Huang ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Case Reports ◽  
Statistical Significance ◽  
Epidemiologic Studies ◽  
Stevens Johnson Syndrome ◽  
Systemic Steroid ◽  
China National Knowledge Infrastructure ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Medical University

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are life-threatening disease. However, there are only few epidemiologic studies of SJS/TEN from China. To analyze the clinical characteristics, causality, and outcome of treatment for SJS/TEN in China, we reviewed case reports of patients with SJS/TEN from the China National Knowledge Infrastructure (CNKI) and Wanfang database from 2006 to 2016 and patients with SJS/TEN who were admitted to the First Affiliated Hospital of Fujian Medical University during the same period. There were 166 patients enrolled, including 70 SJS, 2 SJS/TEN overlap, and 94 TEN. The most common offending drugs were antibiotics (29.5%) and anticonvulsants (24.1%). Carbamazepine, allopurinol, and penicillins were the most common single offending drugs (17.5%, 9.6%, and 7.2%). Chinese patent medicines accounted for 5.4%. There were 76 (45.8%) patients receiving systemic steroid and intravenous immunoglobulin (IVIG) in combination therapy, especially for TEN (80.3%), and others were treated with systemic steroids alone. Mortality rate of combination treatment comparing with steroid alone in TEN patients had no statistical significance. In conclusion, carbamazepine and allopurinol were the leading causative drugs for SJS/TEN in China. Combination of IVIG and steroids is a common treatment for TEN, but its efficacy in improving mortality needs further investigation.

scholarly journals Fatal case of toxic epidermal necrolysis induced by ciproflfl oxacin in a child

2021 ◽  
Vol 12 (Supp 1) ◽  
pp. 26-29
Author(s):  
Thomas Schiestel
Keyword(s):  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Reactions ◽  
Pediatric Population ◽  
Fatal Case ◽  
Stevens Johnson Syndrome ◽  
Delayed Treatment ◽  
Drug Eruptions ◽  
Johnson Syndrome ◽  
Life Threatening

Bullous drug eruptions such as Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare but known adverse reactions of fluoroquinolones. Although uncommon, TEN can be life-threatening for the patient, especially in the context of delayed treatment and in fragile patients such as the pediatric population. In the present case, TEN occurred in a 13-year-old girl with no medical history following initiation of ciprofloxacin treatment for an inguinal cyst. We hope that the case report will make interrogate the practices concerning the use of antibiotics, in particular fluoroquinolones in the context of an use not prescribed by the Marketing Authorization of the drug in children.

scholarly journals Toxic Epidermal Necrolysis/Stevens-Johnson Syndrome at A University Hospital in Saudi: Causative Factors and Outcomes

2022 ◽  
Author(s):  
Amal A Kokandi
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Small Sample Size ◽  
Intravenous Immunoglobulins ◽  
Small Sample ◽  
University Hospital ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Causative Agents ◽  
Life Threatening ◽  
King Abdulaziz University

Abstract Introduction:Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare, life-threatening conditions caused mainly by drugs. Their management relies on the withdrawal of the culprit medication and supportive measures. Different pharmacotherapies have varied effects. However, data related to TEN and SJS in Saudi is limited. This study aimed to identify the causative agents, associated factors, and outcomes of TEN/SJS cases admitted to a teaching hospital (King Abdulaziz University) in Jeddah during the last 10 years.Methods: We retrospectively analyzed the data of TEN/SJS patients admitted to the hospital over the last 10 years.Results: We identified 12 patients with TEN/SJS. Of these, nine survived the condition and were discharged. The culprit medication was identified in eight of them, including antibiotics in six cases and Tegretol and allopurinol in one case each. Most of the patients received systemic steroids and intravenous immunoglobulins.Conclusion: TEN/SJS is mainly caused by medications of which antibiotics are the most implicated. Consistent with other studies, the mortality rate associated with TEN/SJS in Saudi is 25%. Limitations: restricted to a single center and small sample size.

scholarly journals Amoxicillin Induced Steven Johnson’s Syndrome: A Case Report

2020 ◽  
Vol 10 (4-s) ◽  
pp. 220-222
Author(s):  
R Mahendra Kumar ◽  
Sanatkumar Nyamagoud ◽  
Krishna Deshpande ◽  
Ankitha Kotian
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Reports ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Johnson Syndrome ◽  
Oral Consumption ◽  
Life Threatening

Stevens-Johnson syndrome (SJS) is a very rare, potentially fatal skin reaction that is typically the result of reaction to the drug. In particular, SJS is characterized by extensive skin and mucous membrane lesions (i.e. mouth, nose, esophagus, anus, and genitalia), epidermis detachment, and acute skin blisters. In 95 % of case reports, drugs were found to be an important cause for the development of SJS. This story is a case of A 42 year old male hospitalized with rashes all over the body and fever, after oral consumption of Amoxicillin drug for sore throat. This case study discusses the possibility that serious hypersensitivity reactions with Amoxicillin can rarely occur and can be extremely harmful and life-threatening Menacing. Keywords: Toxic Epidermal Necrolysis, Stevens Johnson Syndrome, Adverse drug reaction, Nikolsky’s sign

Suspected Lamotrigine-Induced Toxic Epidermal Necrolysis

1997 ◽  
Vol 31 (6) ◽  
pp. 720-723 ◽  
Author(s):  
Julie J Chaffin ◽  
Steven M Davis
Keyword(s):  
Valproic Acid ◽  
Toxic Epidermal Necrolysis ◽  
Case Reports ◽  
Stevens Johnson Syndrome ◽  
Complex Partial Seizures ◽  
Skin Reactions ◽  
Johnson Syndrome ◽  
Patient Reported ◽  
History Of ◽  
Relationship Of

OBJECTIVE: To describe a patient who developed toxic epidermal necrolysis (TEN) possibly secondary to lamotrigine use. CASE SUMMARY: A 74-year-old white man with a history of probable complex partial seizures was admitted to the neurology service for a prolonged postictal state. His antiepileptic regimen was changed while he was in the hospital to include lamotrigine. After 19 days of hospitalization and 14 days of lamotrigine therapy, the patient became febrile. The next day he developed a rash which progressed within 4 days to TEN, diagnosed by skin biopsy. All suspected drugs were discontinued, including lamotrigine. The patient was treated with hydrotherapy in the burn unit. His symptoms improved and he was discharged from the hospital 26 days after the rash developed. DISCUSSION: During lamotrigine's premarketing clinical trials, the manufacturer reported several cases of Stevens-Johnson syndrome and TEN. There are several published case reports of lamotrigine-induced severe skin reactions. All of these reports included patients being treated with both valproic acid and lamotrigine. Our patient was exposed to phenytoin, carbamazepine, clindamycin, and lamotrigine, but not valproic acid. The patient reported prior use of phenytoin with no skin rash. Carbamazepine was the antiepileptic drug the patient was maintained on prior to his hospital admission, and the symptoms of TEN resolved while he was still receiving carbamazepine. The patient received only two doses of clindamycin, which makes this agent an unlikely cause of TEN. CONCLUSIONS: Because of the temporal relationship of the onset of the patient's rash and several drugs that are known to cause severe rashes, it is not certain which drug was the definite culprit. However, based on the evidence from the literature, lamotrigine appears to be the causative agent.

scholarly journals Meropenem-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in a patient with known type IV penicillin hypersensitivity

2019 ◽  
Vol 12 (8) ◽  
pp. e230144 ◽  
Author(s):  
Muhammad Sameed ◽  
Christine Nwaiser ◽  
Prashant Bhandari ◽  
Sarah A Schmalzle
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Cross Reactivity ◽  
Delayed Hypersensitivity ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Beta Lactam ◽  
Type Iv ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered variants of a disease continuum that results in a life-threatening exfoliative mucocutaneous disease. These are categorised as type IV cell-mediated delayed hypersensitivity reactions, and antibiotics are often implicated as a cause. Penicillins and other beta-lactam antibiotics are known to cause both immediate and delayed hypersensitivity reactions. While immediate IgE-mediated cross-reactivity between penicillins and carbapenems is well studied, less information on the risk of type IV delayed cell-mediated cross-reactivity between the two is available. We present a case of meropenem-induced SJS in a patient with documented history of SJS from amoxicillin. There are few cases of cross-reactivity with carbapenems reported in the literature, but based on the potential for life-threatening reaction, it is likely prudent to avoid the use of any beta-lactams in a patient with a history of SJS, TEN or any other severe cutaneous adverse reactions to another beta-lactam antibiotic.

scholarly journals Levofloxacin induced Stevens-Johnson syndrome/ toxic epidermal necrolysis overlap syndrome: case reports

2014 ◽  
Vol 4 (S3) ◽  
Author(s):  
Maria Gloria Aversano ◽  
Jan Schroeder ◽  
Antonella Citterio ◽  
Joseph Scibilia ◽  
Chiara Gamba ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Case Reports ◽  
Overlap Syndrome ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

scholarly journals Serum Granulysin in Differentiation of Stevens-Johnson Syndrome/toxic Epidermal Necrolysis and Erythema Multiforme

2020 ◽  
Vol 8 (B) ◽  
pp. 381-388
Author(s):  
Tran Thi Huyen ◽  
Pham Dinh Hoa ◽  
Trinh Minh Trang ◽  
Riichiro Abe ◽  
Nguyen Van Thuong ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Body Surface ◽  
Erythema Multiforme ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Drug Reactions ◽  
Skin Manifestation ◽  
Johnson Syndrome ◽  
Life Threatening

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening drug reactions, which lead to massive epidermal necrolysis. Granulysin plays an important role as a key mediator for keratinocyte apoptosis in these conditions. Erythema multiforme (EM) may have skin manifestation similar to SJS/TEN. AIMS: The aim of the study was to compare serum granulysin levels in patients with SJS/TEN and EM as well as to investigate a possible association between serum granulysin levels and the severity of SJS/TEN. METHODS: In total, 48 patients with SJS/TEN, 43 patients with EM, and 20 health controls (HCs) were enrolled. We measured serum granulysin levels using enzyme-linked immunosorbent assay. RESULTS: The average level of serum granulysin in the SJS/TEN patients was 23.0 ng/ml (range 1.2–144.6 ng/ml), significantly higher than that of EM group (20.1 ng/ml; range 8.5–121 ng/ml, p < 0.05) and HCs group (20.8 ng/ml; range 10.1–46.7 ng/ml, p < 0.05). Of 48 SJS/TEN patients, the 25 samples collected <6 days after onset showed higher level of serum granulysin (27.7 ng/ml; range 2.5–144.6 ng/ml) than those collected ≥6 days after onset (17.9 ng/ml; range 1.2–59 ng/ml; p > 0.05). No significant correlation was found between serum granulysin levels and the body surface area affected and the modified-SCORTEN. At the day of re-epithelialization, serum granulysin levels were not different compared with those at the day of hospitalization. CONCLUSIONS: Serum granulysin levels are significantly higher in SJS/TEN group than in EM group. After the onset, serum granulysin levels in patients with SJS/TEN are not a good biomarker to evaluate the severity of the diseases.

scholarly journals ACECLOFENAC-INDUCED STEVENS-JOHNSON SYNDROME AFTER ONE SINGLE DOSE: A MAIDEN CASE REPORT

2018 ◽  
Vol 11 (9) ◽  
pp. 1 ◽  
Author(s):  
Saurabh Agarwal ◽  
Balaji O ◽  
Navin Patil
Keyword(s):  
Case Reports ◽  
Tertiary Care ◽  
Stevens Johnson Syndrome ◽  
Care Hospital ◽  
Skin Reactions ◽  
Johnson Syndrome ◽  
Organ Systems ◽  
Major Organ ◽  
Threatening Condition ◽  
Life Threatening

Drugs are known to cause various adverse drug reactions involving major organ systems. Skin-related adverse reactions are very common and range from a simple rash to life-threatening condition like Stevens-Johnson syndrome. Various drugs are known to cause skin reactions which include antiepileptics, analgesics, antibiotics, and proton-pump inhibitors. Nonsteroidal anti-inflammatory drugs causing life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis are very rare and only few case reports are published. Hence, we report a case of Aceclofenac-induced Stevens-Johnson syndrome after single time administration in a tertiary care hospital in India.

scholarly journals Stevens-Johnson syndrome induced by phenytoin: a case report

2016 ◽  
Vol 6 (1) ◽  
pp. 208
Author(s):  
Lalkota Prakash Bhanu ◽  
Kumara Swamy M. ◽  
Mohammed Nasiruddin ◽  
Naveen H. D. ◽  
Rajesh Venkataraman
Keyword(s):  
Adverse Reaction ◽  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Antiepileptic Drugs ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Adverse Reaction ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Grade 3

Stevens-Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN) are rare (one to two per 10,00,00 population per year) but life threatening adverse drug reactions. Antiepileptic drugs-induced Stevens-Johnson syndrome (SJS) is a life-threatening severe cutaneous adverse reaction, amongst anti-epileptics; carbamazepine and phenytoin are the major culprits. We report here a case of SJS due to phenytoin (CTC vs 2 Grade 3).

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