Beatmung bei Toxisch Epidermaler Nekrolyse

Namdar, Thomas; Stang, Felix; Siemers, Frank; Stollwerck, Peter Leonard; Wild, Tobias von; Mailänder, P.; Lange, Theresa

doi:10.1055/s-0030-1263110

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Topical steroids can help minimize the circle of cicatrization and eyelid abnormalities if there is a lot of irritation. Scarring in the epithelium of the conjunctiva, membranous or pseudomembranous conjunctiva inflammation, ankyloblepharon, or symblepharon, together with other issues such as entropion or lagophthalmos, causes severe dry eye syndrome or vision loss [10,14,15].…”

Section: Clinical Presentation and Evaluationmentioning

confidence: 99%

An Overview on the Evaluation and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Almadfaa¹,

Alattas²,

Aleissa³

et al. 2022

Int j pharm res allied sci

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One of the rare dermatological illnesses that might cause a medical emergency is SJS/TEN. SJS/TEN trigger an aggressive immune reaction to destroy the epithelium of the skin and mucous membranes. They are lifethreatening mucocutaneous responses with death rates as high as 30% and a wide range of acute and chronic morbidities. Therefore, early detection and adequate and early treatment can save the patient's life. To review the evaluation of SJS/TEN clinical manifestations and the different aspects of the management. PubMed database search engine was the preferred method for data selection, and the following keys were used in the mesh (("Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis"[Mesh] ) AND ("evaluation"[Mesh]) OR ("management"[Mesh])). While there is no test or set of criteria that can determine whether or not an individual has Steven-Johnson syndrome or Toxic epidermal Necrolysis, a skin biopsy can assist in determining other illnesses that have clinical manifestations.Provided there is no effective approach to treat SJS/TEN, presently the best approach is to have a great doubt for the syndrome, early clinical diagnosis, immediate discontinuation of suspected causing substance, supportive therapy, and close monitoring for and treatment of high morbidity complications like infection and ophthalmologic sequelae. Moreover, pain control is crucial to retain a sense of the mental and physical wellbeing of the patients.

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Section: Clinical Presentation and Evaluationmentioning

confidence: 99%

An Overview on the Evaluation and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Almadfaa¹,

Alattas²,

Aleissa³

et al. 2022

Int j pharm res allied sci

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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the Pediatric Population

Alerhand¹,

Cassella²,

Koyfman³

2016

Pediatr Emer Care

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe dermatologic reactions with mucocutaneous involvement that carry elevated mortality rates. They differ along a spectrum of severity based upon body surface area affected. These conditions, usually caused by a drug or infection, are believed to result from cell-mediated and often drug-specific cytotoxic reactions against keratinocytes, leading to widespread dermal-epidermal detachment. Studies attempting to identify potential curative therapies such as intravenous immune globulin (IVIG) and corticosteroids remain inconclusive. However, improved outcomes have been demonstrated by early withdrawal of offending medications, early transfer to an intensive care unit or burn unit, and aggressive supportive care. Due to the rare incidence of SJS and TEN, its recurrence among survivors hints at future vulnerability for these patients, and notorious offending medications should thus be avoided. This clinical review will highlight the diagnostic and therapeutic challenges posed by SJS and TEN, while emphasizing the need to maintain them high on the emergency medicine physician's differential. The review will also detail the supportive measures to take for preventing the rapid progression of mucocutaneous complications and subsequent sepsis-related mortality.

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Chronic pulmonary complications due to toxic epidermal necrolysis

Hwang

Kim

et al. 2013

Allergy Asthma Respir Dis

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Toxic epidermal necrolysis (TEN) is the most severe form of skin reactions caused by drugs or infection. Acute pulmonary complications in TEN are often observed. The mortality is especially high in those who suffer chronic pulmonary complications of TEN such as bronchiolitis obliterance, which occur as a consequence of bronchial epithelial injury. We report a case of a 16-year-old male who had required mechanical ventilation due to acute respiratory distress syndrome caused by TEN at 8 years of age. Although the patient initially recovered from acute respiratory distress syndrome, he required mechanical ventilation again due to severe chronic pulmonary complications of bronchiolitis obliterance and bronchiectasis caused by respiratory epithelial detachment. Thereafter, chronic bronchitis and chronic sinusitis has persisted due to mucosal ciliary dysfunction and several episodes of spontaneous pneumothorax has occurred. However, despite these persisting and serious sequelae of TEN, the patient has survived for 8 years. We report a rare case of a patient with long-term chronic pulmonary complications who had previously suffered TEN 8 years ago.

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Beatmung bei Toxisch Epidermaler Nekrolyse

Abstract: Mechanical ventilation in TEN patients is associated with an increased mortality rate, but the timing of initiation of mechanical ventilation does not affect the patient survival rates.

Cited by 3 publications

References 10 publications

An Overview on the Evaluation and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

An Overview on the Evaluation and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the Pediatric Population

Chronic pulmonary complications due to toxic epidermal necrolysis

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