Blindness, Anonychia, and Oral Mucosal Scarring as Sequelae of the Stevens‐Johnson Syndrome

Hansen, Ronald C.

doi:10.1111/j.1525-1470.1984.tb01133.x

Cited by 16 publications

(5 citation statements)

References 12 publications

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“…Nail changes occur in up to 50% of patients . Shedding of nails (onychomadesis) may occur a few weeks after the acute episode, and is due to complete nail matrix arrest during SJS/TEN. In up to 20% of patients such nail loss is permanent .…”

Section: Cutaneous Sequelaementioning

confidence: 99%

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

2017

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse reactions to drugs that cause a life-threatening eruption of mucocutaneous blistering and epithelial sloughing. While the acute complications of SJS/TEN are well described, it is increasingly recognized that survivors may develop delayed sequelae, some of which can be associated with significant morbidity. Studies of long-term SJS/TEN outcomes mostly focus on mucocutaneous and ocular complications. However, other internal organs, such as the respiratory tract and gastrointestinal tract, can be affected. Psychological sequelae are also frequent following the trauma of widespread epidermal necrolysis. An appreciation of the 'chronic' phase of SJS/TEN is needed by clinicians caring for individuals who have survived the acute illness. This review aims to provide an update on the breadth and range of sequelae that can affect patients in the months and years following an acute episode of SJS/TEN.

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Section: Cutaneous Sequelaementioning

confidence: 99%

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

2017

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“…Acquired causes of hyponychia include trauma, onychotillomania 60 lichen planus 61 severe acrosclerosis, syringomyelia 62 Stevens–Johnson syndrome 63 and cicatricial pemphigoid 64 …”

Section: Widespread Nail Matrix Insultmentioning

confidence: 99%

Diseases of the generative nail apparatus. Part I: Nail matrix

2002

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Disorders of the generative structures of the nail produce a characteristic set of outcomes. The matrix is the seat of nail development and diseases or insults of this germinative epithelium will tell a story in the signs that unfold in the ensuing nail growth. This story will be influenced by the intensity, duration and extent of this pathology. A method of categorizing changes associated with the generative matrix of the nail will be presented.

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“…Studies reported more than half of the TEN survivors suffered various serious long-term complications [33], including blindness [34]. In addition, there may be medico-legal consequence if testing recommendations from regulatory agencies are not followed.…”

Section: Discussionmentioning

confidence: 99%

Real-World Efficiency of Pharmacogenetic Screening for Carbamazepine-Induced Severe Cutaneous Adverse Reactions

2014

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ObjectivesWe evaluated the cost and efficiency of routine HLA-B*15∶02 screening to prevent carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (CBZ-SJS/TEN) in Hong Kong.MethodsData were extracted from patients who commenced CBZ as the first-ever AED treatment or tested for HLA-B*15∶02 allele in three years before policy implementation (pre-policy: 16 September 2005 to 15 September 2008) and three years after (post-policy: 16 September 2008 to 15 September 2011). Using published unit costs, we estimated the cost of screening by comparing the costs to prevent and treat CBZ-SJS/TEN. We compared the number of person-tests needed and the cost to prevent resultant death with cancer screening programs.ResultsThe number of screening tests needed to prevent one case of CBZ-SJS/TEN was 442, and to prevent one resultant death was 1,474 to 8,840. The screening cost was $332 per person, of which 42% was attributed to an additional consultation to review result and prescribe appropriate medication. HLA-B*15∶02 screening expended $146,749 to prevent a case of CBZ-SJS/TEN, and $489,386– $2,934,986 to prevent a resultant death. The corresponding numbers of tests and costs for mammography and Pap smear to prevent death due to breast and cervical cancers were 7,150 and 7,000, and $614,900 and $273,000, respectively. Comparing to the SJS/TEN treatment cost, HLA-B*15∶02 screening would become cost saving if a point-of-care test of less than $37 was available.ConclusionsHLA-B*15∶02 screening is as efficient as mammography and Pap smear in preventing death. Development of point-of-care testing will vastly improve efficiency.

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Blindness, Anonychia, and Oral Mucosal Scarring as Sequelae of the Stevens‐Johnson Syndrome

Cited by 16 publications

References 12 publications

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

Diseases of the generative nail apparatus. Part I: Nail matrix

Real-World Efficiency of Pharmacogenetic Screening for Carbamazepine-Induced Severe Cutaneous Adverse Reactions

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