Database : MEDLINE
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[PMID]: 29524279
[Au] Autor:Dumas M; Hua C; Hotz C; Velter C; Duong TA; Maraffi T; Ortonne N; Hüe S; Fardet L; de Prost N; Wolkenstein P; Ingen-Housz-Oro S; Chosidow O
[Ad] Address:Dermatology department, AP-HP, Henri Mondor hospital, Créteil, France.
[Ti] Title:Epidermal necrolysis and autoimmune diseases: two more observations supporting the concept that "toxic" epidermal necrolysis can be "non-toxic".
[So] Source:J Eur Acad Dermatol Venereol;, 2018 Mar 10.
[Is] ISSN:1468-3083
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Toxic epidermal necrolysis (TEN, Lyell syndrome) and Stevens-Johnson syndrome are severe cutaneous adverse reactions to drugs characterized by epidermal necrolysis (EN). However, in 15% of cases, no causative drug is identified. In these cases, other triggers such as Mycoplasma pneumoniae have been described. Furthermore, the role of lupus as triggering factor has been suggested. We report 2 cases of EN without any drug causality, revealing autoimmune diseases as a cause. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1111/jdv.14935

  2 / 5319 MEDLINE  
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[PMID]: 29505509
[Au] Autor:Xu L; Zhu Y; Yu J; Deng M; Zhu X
[Ad] Address:Department of Children's Critical Care Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Title:Nursing care of a boy seriously infected with Steven-Johnson syndrome after treatment with azithromycin: A case report and literature review.
[So] Source:Medicine (Baltimore);97(1):e9112, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. SJS in children is not common but potentially serious disease. But the epidemiology of SJS in China is not well defined. PATIENT CONCERNS: A 6-year-old boy was initially diagnosed as pneumonia admitted to hospital after admission, and the body appears red rash with blisters, skin damage, lip debaucjed, repeated high fever, and rapid progression. DIAGNOSES: SJS often results from an allergy reaction response to a range of drugs. It is a clinical diagnosis suggested by fever and malaise followed by an extensive painful, nonblanching, macular rash that commonly progresses to blistering or sloughing, and mucositis. INTERVENTIONS: The boy was treated with continuous renal replacement therapy, anti-infection therapy, high-dose glucocorticoid treatment, and symptomatic treatment. OUTCOMES: The patient was recovered after 33 days of treatment. LESSONS: The current treatment is mainly symptomatic treatment, and for the patient, it is important to make skin care related well, included early out blisters at effusion, reducing skin ulceration of the mucosa area, keeping skin clean, removing mucosa secretion and blood clots, doing eye care related, preventing the complications, ensuring adequate intake of nutrition and warm and so on.
[Mh] MeSH terms primary: Anti-Bacterial Agents/adverse effects
Azithromycin/adverse effects
Skin Care/nursing
Stevens-Johnson Syndrome/nursing
[Mh] MeSH terms secundary: Child
Humans
Male
Pneumonia/drug therapy
Stevens-Johnson Syndrome/etiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Anti-Bacterial Agents); 83905-01-5 (Azithromycin)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009112

  3 / 5319 MEDLINE  
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[PMID]: 29521632
[Au] Autor:Yang F; Chen SA; Wu X; Zhu Q; Luo X
[Ad] Address:Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
[Ti] Title:Overexpression of cytotoxic proteins correlates with liver function impairment in patients with drug reaction with eosinophilia and systemic symptoms (DRESS).
[So] Source:Eur J Dermatol;28(1):13-25, 2018 Feb 01.
[Is] ISSN:1952-4013
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:Drug reaction with eosinophilia and systemic symptoms (DRESS) is characterised by skin rash and multivisceral involvement. The liver is the organ most frequently affected and the degree of liver function impairment often correlates with the mortality rate of DRESS. We aimed to examine the expression of cytotoxic proteins, including soluble Fas ligand (sFasL), TNF-α, granulysin, perforin, and granzyme B in the sera and skin lesions of patients with DRESS and evaluate their clinical significance. Our cohort consisted of 21 patients with DRESS and control groups including 39 patients with Stevens-Johnson syndrome/toxic epidermal necrolysis, 21 patients with maculopapular eruption, and 29 normal controls. Concentrations of cytotoxic proteins in the sera were measured using enzyme-linked immunosorbent assays. Tissue samples were also obtained from typical skin lesions, and immunohistochemical staining was conducted to assess the local expression of cytotoxic proteins. We found that sFasL and granzyme B were significantly overexpressed in the sera of DRESS patients compared to normal controls. Furthermore, the levels of sFasL, perforin, and granzyme B significantly correlated with the serum level of liver enzymes in DRESS patients. Immunohistochemical examination also showed overexpressed cytotoxic proteins in cutaneous DRESS lesions. Cytotoxic proteins may play a vital role in the pathogenesis of DRESS, and serum sFasL, perforin, and granzyme B may also be involved in liver function impairment in DRESS patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1684/ejd.2017.3211

  4 / 5319 MEDLINE  
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[PMID]: 29400697
[Au] Autor:Wang CW; Yang LY; Chen CB; Ho HC; Hung SI; Yang CH; Chang CJ; Su SC; Hui RC; Chin SW; Huang LF; Lin YY; Chang WY; Fan WL; Yang CY; Ho JC; Chang YC; Lu CW; Chung WH; and the Taiwan Severe Cutaneous Adverse Reaction (TSCAR) Consortium
[Ad] Address:Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital (CGMH), Linkou, Taipei and Keelung, Taiwan.
[Ti] Title:Randomized, controlled trial of TNF-α antagonist in CTL-mediated severe cutaneous adverse reactions.
[So] Source:J Clin Invest;128(3):985-996, 2018 Mar 01.
[Is] ISSN:1558-8238
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Cytotoxic T lymphocyte-mediated (CTL-mediated) severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), are rare but life-threatening adverse reactions commonly induced by drugs. Although high levels of CTL-associated cytokines, chemokines, or cytotoxic proteins, including TNF-α and granulysin, were observed in SJS-TEN patients in recent studies, the optimal treatment for these diseases remains controversial. We aimed to evaluate the efficacy, safety, and therapeutic mechanism of a TNF-α antagonist in CTL-mediated SCARs. METHODS: We enrolled 96 patients with SJS-TEN in a randomized trial to compare the effects of the TNF-α antagonist etanercept versus traditional corticosteroids. RESULTS: Etanercept improved clinical outcomes in patients with SJS-TEN. Etanercept decreased the SCORTEN-based predicted mortality rate (predicted and observed rates, 17.7% and 8.3%, respectively). Compared with corticosteroids, etanercept further reduced the skin-healing time in moderate-to-severe SJS-TEN patients (median time for skin healing was 14 and 19 days for etanercept and corticosteroids, respectively; P = 0.010), with a lower incidence of gastrointestinal hemorrhage in all SJS-TEN patients (2.6% for etanercept and 18.2% for corticosteroids; P = 0.03). In the therapeutic mechanism study, etanercept decreased the TNF-α and granulysin secretions in blister fluids and plasma (45.7%-62.5% decrease after treatment; all P < 0.05) and increased the Treg population (2-fold percentage increase after treatment; P = 0.002), which was related to mortality in severe SJS-TEN. CONCLUSIONS: The anti-TNF-α biologic agent etanercept serves as an effective alternative for the treatment of CTL-mediated SCARs. TRIAL REGISTRATION: ClinicalTrials.gov NCT01276314. FUNDING: Ministry of Science and Technology of Taiwan.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review

  5 / 5319 MEDLINE  
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[PMID]: 29181714
[Au] Autor:Wynberg E; Williams E; Tudor-Williams G; Lyall H; Foster C
[Ad] Address:The Family Clinic, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London, UK. elke.wynberg@stcatz.ox.ac.uk.
[Ti] Title:Discontinuation of Efavirenz in Paediatric Patients: Why do Children Switch?
[So] Source:Clin Drug Investig;38(3):231-238, 2018 Mar.
[Is] ISSN:1179-1918
[Cp] Country of publication:New Zealand
[La] Language:eng
[Ab] Abstract:BACKGROUND: Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is used globally as first-line antiretroviral therapy (ART) in combination with a dual nucleoside backbone in adults and children from 3 years of age. Up to 40% of adults taking efavirenz report central nervous system (CNS) adverse effects, and the rates of discontinuation of efavirenz-based treatment are higher than other first-line regimens. Data on efavirenz discontinuation are more limited for children and adolescents. OBJECTIVE: In this study, we aimed to describe our single-centre paediatric experience of efavirenz. METHODS: Retrospective case-note audit of children and adolescents with perinatally acquired HIV who ever received efavirenz. RESULTS: From 1998 and 2014, 51 children and adolescents aged ≤ 18 years received efavirenz-based treatment. Median age at efavirenz initiation was 9.4 years (interquartile range [IQR] 7-13). More than half (30/51; 59%) subsequently switched off efavirenz-15 (29%) following virological failure with NNRTI-associated resistance mutations, and 16 (30%) after reporting adverse effects. Of those who experienced adverse effects, one-fifth (19.6%) described CNS adverse effects, including sleep disturbance, reduced concentration, headaches, mood change and psychosis. Four children (three males) developed gynaecomastia, two developed hypercholesterolaemia, and one child developed Stevens-Johnson syndrome. Comparison between those reporting side effects and the rest of the cohort showed no difference in age, sex, initial CD4 cell count, viral suppression, length of efavirenz-based treatment, weight, or efavirenz dose per kilogram. Median time to switch was 25 months (IQR 10-71) in those who experienced side effects and 22 months (IQR 12-50) for virological failure. One individual experienced both virological failure and adverse effects. CONCLUSION: Almost two-thirds of this paediatric cohort switched from efavirenz-based treatment to an alternative regimen, due in equal proportions to both virological failure and toxicity. The majority of side effects involved the CNS. First-line regimens with improved tolerability and a higher genetic barrier to resistance should be the preferred option for children.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1007/s40261-017-0605-1

  6 / 5319 MEDLINE  
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[PMID]: 29506464
[Au] Autor:Vaghela JJ; Nimbark VN; Chavda BC; Mehta HH; Purohit BM
[Ad] Address:Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar - 364001 (Gujarat), India.
[Ti] Title:A Rare Case Report of Toxic Epidermal Necrolysis due to Ofloxacin.
[So] Source:Curr Drug Saf;, 2018 Mar 02.
[Is] ISSN:2212-3911
[Cp] Country of publication:United Arab Emirates
[La] Language:eng
[Ab] Abstract:Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, rare and life-threatening conditions, for which etiopathogenesis, as well as pharmacotherapy, is yet uncleared. A 45-year-old male patient by chance on re-exposure to Ofloxacin developed severe cutaneous adverse drug reaction (SCADR), diagnosed with toxic epidermal necrolysis. His comorbid conditions and systemic complications of TEN were lead him to death. In developing country where antibiotics especially fluoroquinolones widely prescribed, a physician should be now vigilant for such kind of SCADRs because of increasing numbers of such kind of reports.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.2174/1574886313666180302124012

  7 / 5319 MEDLINE  
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[PMID]: 27772655
[Au] Autor:Gupta PC; Ram J
[Ad] Address:Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
[Ti] Title:Re: Sharma et al.: Adjuvant role of amniotic membrane transplantation in acute ocular Stevens-Johnson syndrome: a randomized control trial (Ophthalmology 2016;123:484-91).
[So] Source:Ophthalmology;123(11):e66-e67, 2016 11.
[Is] ISSN:1549-4713
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER; COMMENT
[Em] Entry month:1610
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process

  8 / 5319 MEDLINE  
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[PMID]: 29487020
[Au] Autor:Saka B; Dzidzinyo K; Akakpo S; Téclessou J; Nouhou Diori A; Maneh N; Mahamadou G; Gnassingbé W; Abilogun-Chokki A; Mouhari-Toure A; Boubacar YA; Kombaté K; Balo K; Tchangai-Walla K; Pitché P
[Ad] Address:Service de dermatologie et IST, CHU de Sylvanus Olympio, université de Lomé, BP 30785, Lomé, Togo. Electronic address: barthelemysaka@yahoo.fr.
[Ti] Title:Facteurs de risque associés à la sévérité de l'atteinte oculaire au stade aigu du syndrome de Stevens-Johnson et de la nécrolyse épidermique toxique en Afrique subsaharienne. [Factors associated with the severity of acute ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa].
[So] Source:Ann Dermatol Venereol;, 2018 Feb 24.
[Is] ISSN:0151-9638
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:AIM: The purpose of this study was to identify risk factors associated with the severity of acute ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) in sub-Saharan Africa. PATIENTS AND METHOD: A retrospective study was carried out at the dermatology department in collaboration with the ophthalmology department for SJS/TEN patients between January 2000 and December 2016 in Lomé (Togo). The severity of acute ocular involvement was evaluated using the Power classification, and the drug eruption score was assessed using de Bastuji-Garin classification. RESULTS: A total of 107 cases of SJS/TEN (84 cases of SJS, 20 cases of TEN and 3 cases of overlap syndrome) were analyzed. There were 71 women and 36 men, with an average age of 32.3±12.5 years (range: 5 to 75 years). Sulfonamides (37.4%) were the most commonly used drugs followed by nevirapine (22.4%). HIV serology was positive in 46 (58.2%) of the 79 patients tested. A total of 54 (50.5%) patients had acute ocular involvement, which was mild in 29.9% of patients, moderate in 13.1% and severe in 7.5%. In multivariate analysis, exposure to sulfadoxine was the sole factor associated with moderate or severe acute ocular involvement in SJS/TEN (adjusted odds ratio=3.3; 95% CI=[1.1; 10.2]). CONCLUSION: Exposure to sulfadoxine was identified in our study as a risk factor associated with the severity of acute ocular involvement in SJS/TEN. Multicenter studies should be conducted in sub-Saharan Africa to confirm this associated risk factor.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher

  9 / 5319 MEDLINE  
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[PMID]: 29469760
[Au] Autor:Conner CD; McKenzie E; Owen CE; Callen JP
[Ti] Title:The use of cyclosporine for Stevens-Johnson syndrome-toxic epidermal necrolysis spectrum at the University of Louisville: A case series and literature review.
[So] Source:Dermatol Online J;24(1), 2018 01 01.
[Is] ISSN:1087-2108
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Cyclosporine therapy for Stevens-Johnson syndrome-toxic epidermal necrolysis (SJSTEN) was first reported in the literature by Renfro et al. in 1989. Herein we report an additional 4 cases of SJS-TEN treated with cyclosporine. METHODS: Case information was collected retroactively at the University of Louisville Hospital in Louisville, KY. All cases had a diagnosis of SJS or TEN by a dermatologist. All patients were ≥18 years of age and treated with cyclosporine during their admission. RESULTS: Three of four patients re-epithelialized within an average of 3.67 days of starting 3-4 mg/kg/day of cyclosporine. One patient passed away, likely due to advanced endometrial cancer. DISCUSSION: We provide a review of the literature on cyclosporine use for SJS/TEN, including various outcome measures - stabilization (cessation of new lesions), time to re-epithelialization, mortality rate, and hospital length of stay and, where available, comparison to other systemic agents. CONCLUSION: The outcomes appear to be consistent with rapid re-epithelialization and low mortality as seen in many previous reports. Treating SJS-TEN with systemic agents including cyclosporine will remaincontroversial because the vast majority of data comes from case reports, case series, or small open prospective trials.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process

  10 / 5319 MEDLINE  
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[PMID]: 29484861
[Au] Autor:Lahav Z; Nasser M; Khoury T
[Ad] Address:Department of Internal Medicine A, Hebrew University-Hadassah Medical Center.
[Ti] Title:[STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS AS A PARA-NEOPLASTIC SYNDROME FOR B-CELL LYMPHOMA].
[So] Source:Harefuah;157(2):85-86, 2018 Feb.
[Is] ISSN:0017-7768
[Cp] Country of publication:Israel
[La] Language:heb
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process


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