A Review of the Pathogenesis of Toxic Epidermal Necrolysis

Kinoshita, Yoshimasa; Saeki, Hidehisa

doi:10.1272/jnms.83.216

Cited by 23 publications

(19 citation statements)

References 48 publications

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“…6 This condition involves the apoptosis of keratinocytes by two pathways like intrinsic pathway and extrinsic pathway which involves the apoptosis inducing factors like reactive oxygen species, TNFα, Interleukin-2, cytotoxic proteins like granulising and perforin-granzyme. 7 Other existing evidences suggest that this condition was also associated with the dermal sweat duct alterations and vaculopathy but there were no alterations in this case were reported. 8 We calculated the SCORETEN score for this patient to estimate severity of illness and he was found to be only associated with only one risk factor that is >10% of epidermal detachment hence obtained the score of 1 point that shows less significant mortality of 3.2% in this reported case as he was just in the acute or initial stage of the condition but whereas score of 5 or >5 shows high mortality rate of 90%.…”

Section: Discussionmentioning

confidence: 52%

Amoxicillin induced toxic epidermal necrolysis

Narasimha¹,

Kalpana²

2020

Int J Basic Clin Pharmacol

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Toxic epidermal necrolysis (TEN) is a rare life-threatening adverse drug reaction associated with mucocutaneous eruptions and peeling of skin (sloughing) mostly caused by drugs like sulphonamides, beta lactams, carbamazepine and non-steroidal anti-inflammatory drugs (NSAIDs). Amoxicillin is a broad spectrum, bactericidal, Beta-lactam antibiotic used in treatment of various infections. Here by we have reported the case of amoxicillin induced severe toxic epidermal necrolysis. A Patient admitted in the hospital with the symptoms of epidermal sloughing that resulted in bare dermis as he received Amoxicillin drug for his diagnosis of fever. After clear examination TEN was confirmed and suspected with the cause due to Amoxicillin. The drug was stopped and patient was treated with other drugs for symptomatic cure. The patient was recovered from his condition and improved significantly.

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Section: Discussionmentioning

confidence: 52%

Amoxicillin induced toxic epidermal necrolysis

Narasimha¹,

Kalpana²

2020

Int J Basic Clin Pharmacol

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“…There is still much to be investigated regarding the pathogenesis of TEN, and new findings may contribute to the identification of an effective active intervention strategy 43 . Although difficult to perform, randomized controlled trials for available active interventions should be performed to better clarify their potential efficacy.…”

Section: Resultsmentioning

confidence: 99%

A Review of the Active Treatments for Toxic Epidermal Necrolysis

Kinoshita

Saeki

2017

J Nippon Med Sch

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Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction associated with the separation of skin and mucous membranes at the dermal-epidermal junction. Although it is rare, many treatments have been trialed because of its high mortality rate. Active interventions performed to date include the use of systemic corticosteroids, intravenous immunoglobulins (IVIg), cyclosporine, plasmapheresis, antitumor necrosis factor drugs and N-acetylcysteine, but none has been established as the most effective therapy. IVIg and short-term high-dose corticosteroids were regarded as the most promising treatments for TEN in a comprehensive review of all reported TEN cases from 1975 2003. When used with an appropriate dose and timing, the beneficial effects of IVIg can be maximized. Although no randomized controlled trials have been conducted, cyclosporine and plasmapheresis are considered to be beneficial.As no gold standard for active intervention for TEN has been established, the choice of treatment relies partly on the available guidelines and the experience of the dermatologist. There is still much to be investigated regarding the pathogenesis of TEN, and new findings may contribute to the identification of an effective active intervention strategy. (J Nippon Med Sch 2017; 84: 110 117)

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“…According to clinician experience, this increased non‐adherence particularly in school going children. Also, carbamazepine has a greater risk of causing Stevens‐Johnson Syndrome and toxic epidermal necrolysis . Carbamazepine is mainly prescribed for partial seizures while sodium valproate is preferred for both partial and generalized seizures.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and comparison of the utilization of anti‐epileptic drugs in Indian paediatric patients with global usage data

Panda

George

Parekh

et al. 2019

J Pharm Health Serv Res

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Objectives To evaluate the utilization pattern of anti-epileptic drugs (AEDs) in Indian paediatric patients and compare it with the global usage data. Methods Paediatric patients (≤18 years) with a confirmed diagnosis of epilepsy and prescribed with at least one AED were included in the study from a child neurology clinic in Pune, Maharashtra, India. The data pertaining to the type of epilepsy, and drug therapy was obtained retrospectively. The prescribing pattern of AEDs was identified and compared with the drug utilization pattern of the Asian and European countries from a systemic literature review. Key findings Out of the 343 paediatric patients enrolled in the study, 55.6% were males. Thirty-four per cent of the patients were under the age group of 2-6 years. More than half (60.5%) of the patients were diagnosed with generalized seizures, with tonic-clonic seizures (48%) being the most common among them. Out of the 37.9% of patients diagnosed with partial epilepsy, simple partial seizure was the most common type. The most commonly prescribed drug was sodium valproate for both generalized and partial seizures. Levetiracetam was found to be the preferred newer AED for management of generalized epilepsy. Similar prescribing pattern was seen in Asian countries where sodium valproate was the most preferred AED followed by levetiracetam and oxcarbazepine. Sodium valproate was also highly prescribed in European countries while levetiracetam and oxcarbazepine were underused. Two hundred and seven patients (60%) were managed on monotherapy.Conclusions Older generation AEDs are still used in majority of patients as mono and dual therapy. Among the newer generation AEDs, there is an increase in the utilization of levetiracetam. Prescription of AEDs in our study goes in line with Asian countries but differs with the European counterparts due to various reasons.

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A Review of the Pathogenesis of Toxic Epidermal Necrolysis

Cited by 23 publications

References 48 publications

Amoxicillin induced toxic epidermal necrolysis

Amoxicillin induced toxic epidermal necrolysis

A Review of the Active Treatments for Toxic Epidermal Necrolysis

Evaluation and comparison of the utilization of anti‐epileptic drugs in Indian paediatric patients with global usage data

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