Evaluation of Etanercept for Treatment of Reactive Infectious Mucocutaneous Eruption

Miller, Marina; Kamath, Sonia; Hughes, Meagan; Harter, Nicole; Luu, Minnelly

doi:10.1001/jamadermatol.2020.5166

Cited by 12 publications

(16 citation statements)

References 7 publications

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“…In fact, the use of antibiotics to treat community acquired pneumonia in patients with RIME has been emphasized [ 69 , 70 ]. One study examined the role of etanercept treatment in RIME and showed that this therapy led to improvement in physical findings within 2 days of drug administration [ 71 ]. However, this study is limited by its small sample size ( n = 6) and treatment with antibiotics in 5/6 patients prior to administration of etanercept, which could also have contributed to the observed improvement.…”

Section: Clinical Updatesmentioning

confidence: 99%

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

et al. 2021

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Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. They are associated with significant morbidity and mortality, and early diagnosis and treatment is critical in achieving favorable outcomes for patients. In this scoping review, Excerpta Medica dataBASE and PubMed were searched for publications that addressed recent advances in the diagnosis and management of the disease. Multiple proteins (galectin 7 and RIP3) were identified that are promising potential biomarkers for SJS/TEN, although both are still in early phases of research. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN. Due to the rare nature of the disease, there is a lack of prospective, randomized controlled trials and conducting these in the future would provide valuable insights into the management of this disease.

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Section: Clinical Updatesmentioning

confidence: 99%

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

et al. 2021

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“…Targeted antibiotic therapy can be used to address specific underlying infections, and rarely immunosuppressive agents such as cyclosporine and etanercept have been used for severe cases. 10 , 11 It is unclear if antiviral COVID‐19 therapies such as nirmatrelvir/ritonavir will have any effect on the incidence and natural history of RIME. However, given the historical use of antibiotics for the treatment of RIME induced by bacterial infections, further studies should be completed on the utility of these antiviral therapies in COVID‐19‐induced RIME.…”

Section: Discussionmentioning

confidence: 99%

Reactive infectious mucocutaneous eruption following COVID‐19 in an adolescent boy: Case report and review of the literature

Mahama¹,

Kojder

Thibodeaux

et al. 2022

Pediatric Dermatology

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Reactive infectious mucocutaneous eruption (RIME) is a mucosal‐predominant eruption that usually affects two or more mucosal sites. We present a case of RIME secondary to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and provide a brief review of the literature with a focus on the natural history and response to treatment. This entity may require inpatient management and systemic corticosteroids for symptom control in the pediatric population.

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“…In an adult randomized controlled trial (RCT) of SJS/TEN, ETN showed benefit compared to corticosteroids for healing time. 17 Our patient received an initial dose of 0.6 mg/kg/dose SC based on the RCT dosing ( Table 5 ) with a significant stabilization in mucocutaneous lesions that seemed to reverse when IVIG was administered within 24 h. 5 , 18 , 17 Stabilization, when new skin lesions stop developing, is the goal of intervention, and thereafter, healing occurs naturally. We theorize that IVIG may have accelerated catabolism of ETN via saturation of the neonatal Fc receptor and neutralized ETN via anti-idiotypic antibodies that could bind to the Fc portion of ETN.…”

Section: Discussionmentioning

confidence: 99%

“… 23 , 24 A second dose of ETN has been required when RIME continues to progress but in those cases (unlike our case), temporary stabilization prior to progression was not described. 5 …”

Section: Discussionmentioning

confidence: 99%

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Reactive infectious mucocutaneous eruption – repeat etanercept after intravenous immunoglobulin: A case report

Tonkin

Ladha

Johnson

et al. 2022

SAGE Open Medical Case Reports

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Reactive infectious mucocutaneous eruption is a recently distinguished mucosal-predominant blistering eruption triggered by respiratory infections. We describe a previously healthy 11-year-old Black female with rapidly progressive mucocutaneous blistering after prodromal respiratory infection symptoms. Reactive infectious mucocutaneous eruption was suspected and treated with systemic corticosteroids followed by etanercept. Twenty-four hours after etanercept, the diagnosis of multisystem inflammatory syndrome in children was raised and intravenous immunoglobulin was given. Rapidly worsening mucocutaneous disease ensued but was controlled by a second dose of etanercept. Our case highlights the following: (1) the novel observation of possible interaction/neutralization of etanercept by intravenous immunoglobulin, (2) the challenging differential diagnosis of multisystem inflammatory syndrome in children for reactive infectious mucocutaneous eruption patients in the Coronavirus disease 2019 (COVID-19) pandemic, and (3) the role of early treatment to prevent dyspigmentation.

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Evaluation of Etanercept for Treatment of Reactive Infectious Mucocutaneous Eruption

Cited by 12 publications

References 7 publications

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

Reactive infectious mucocutaneous eruption following COVID‐19 in an adolescent boy: Case report and review of the literature

Reactive infectious mucocutaneous eruption – repeat etanercept after intravenous immunoglobulin: A case report

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