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- Title
Toxic epidermal necrolysis: a study of 3 cases and review.
- Authors
Wełniak, Adam; Lipska, Patrycja; Watoła, Wiktoria; Grabowska, Nicole; Marek-Józefowicz, Luiza; Czajkowski, Rafał
- Abstract
Toxic epidermal necrolysis syndrome is a life-threatening adverse skin reaction requiring admission to dermatology wards or intensive care units. Preceded by fever and general malaise, the condition leads to the separation of the epidermis from the dermis resulting in large erosions. Epidermal loss results in loss of fluid and electrolytes as well as an increased risk of infections. The above paper presents a description of 3 patients treated for toxic epidermal necrolysis. The first patient, in addition to typical skin involvement, had lesions on the eyes and in the throat, thus the treatments required cooperation with a laryngologist and ophthalmologist. The second patient, due to his mental disorder, caused numerous difficulties in the ward, which disrupted its work, as the ward does not have doctors on duty 24 hours a day. A third patient with cirrhosis had a rapidly progressing disease that did not respond to any form of treatment. For the first two patients, intravenous immunoglobulin therapy proved crucial for recovery, while the third patient died due to a lack of underlying disease treatment options. The most common cause of Lyell’s syndrome is medications, mainly antiepileptics, and antibiotics, although the list of substances that can cause the syndrome has been growing in recent years. There are no new global guidelines and current ones emphasize drug withdrawal, topical treatment and early assessment via the SCORTEN scale. The role of systemic steroid therapy, remains unclear, although recent evidence suggests that it could potentially reduce mortality. Cyclosporine and intravenous immunoglobulins have been gaining prominence in recent years for the treatment of this condition.
- Subjects
TOXIC epidermal necrolysis; EXANTHEMA; INTRAVENOUS immunoglobulins; EXFOLIATIVE dermatitis; DRUG allergy; DISEASE complications
- Publication
Forum Dermatologicum, 2023, Vol 9, Issue 4, p154
- ISSN
2451-1501
- Publication type
Article
- DOI
10.5603/fd.98170