Previous studies have found an association between HLA‐B*1502 allele and lamotrigine‐induced Stevens‐Johnson syndrome (SJS)/ toxic epidermal necrosis (TEN) spectrum in Han Chinese populations. This study aims to investigate the association between HLA‐B*1502 and lamotrigine‐ or phenytoin‐ induced SJS/TEN in an Iranian population. The medical records of twenty‐eight lamotrigine‐induced SJS/TEN patients and twenty‐five lamotrigine‐tolerant controls as well as eight phenytoin‐induced SJS/TEN and twelve phenytoin‐tolerant controls were extracted between March 2013 and March 2019 from the university hospitals in Mashhad, Iran. The presence of HLA‐B*1502 allele was determined using real‐time polymerase chain reaction (PCR). Among lamotrigine‐induced patients with SJS/TEN, 11 (39.3%) patients tested positive for the HLA‐B*1502 while only 3 (12.0%) of the lamotrigine‐tolerant controls tested positive for this allele. The risk of lamotrigine‐induced SJS/TEN was significantly higher in patients with HLA‐B*1502, with an odds ratio (OR) of 4.74 [95% confidence interval (CI) 1.14–19.73, p = 0.032]. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HLA‐B*1502 for lamotrigine‐induced SJS/TEN was 39.29%, 88.00%, 78.57% and 56.41%, respectively. The HLA‐B*1502 allele was present in 2 (25.0%) of phenytoin‐induced SJS/TEN cases and 5 (41.7%) of the phenytoin‐tolerant controls tested positive for HLA‐B*1502 allele. The risk of phenytoin‐induced SJS/TEN was not higher in the patients with HLA‐B*1502 (OR = 0.467 [95% confidence interval (CI) 0.065‐3.34, p = 0.642]). Lamotrigine‐induced SJS/TEN is associated with HLA‐B*1502 allele in an Iranian population but this is not the case for phenytoin‐induced SJS/TEN.
Pruritus is one of the most common complaints among patients referred to a dermatology clinic. “Chronic generalized pruritus” is described as the sensation of itching on the entire body surface, which lasts at least 6 or more weeks. This symptom can be a disabling phenomenon for patients and may sometimes interfere with daily activities such as sleep. If specific dermatological findings are observed, the physician easily comes to a diagnosis and treats the condition, whereas, when primary lesions are not detected, the diagnosis can become challenging, and some patients have to undergo extensive evaluations. The association between some systemic disorders and chronic generalized pruritus is widely known and confirmed. Many infections have been associated with pruritus, but few are considered to cause chronic generalized pruritus without any characteristic skin lesions. We aimed to gather all the available data on infectious causes of chronic generalized pruritus with no diagnostic cutaneous lesions to assist fellow physicians in the process of evaluation of these challenging cases.
Harlequin ichthyosis is the most extreme form of all autosomal recessive congenital ichthyosis caused by biallelic loss of function mutations in an ABC transporter gene/ABCA12. 1,2 Respiratory insufficiency and infection occasionally do not permit the affected neonates to survive. However, the introduction of systemic retinoids and improvement of neonatal care has resulted in a prolonged survival rate. The survivor will develop exfoliative erythroderma, palmoplantar keratoderma, persistent ectropion, eclabion, and joint contractures.The tautness of eyelid skin and transepidermal dehydration lead to severe and cicatricial ectropion, causing further exposure keratopathy and eventually, corneal ulceration. 3 Although corneal damage might
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.