Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features

Cho, Yung-Tsu; Lin, Jheng-Wei; Chen, Yi‐Chun; Chang, Chia‐Hsuin; Hsiao, Cheng–Hsiang; Chung, Wen‐Hung; Chu, Chia‐Yu

doi:10.1016/j.jaad.2013.11.015

Cited by 99 publications

(100 citation statements)

References 20 publications

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“…The hallmark of FDE is persistent hyperpigmentation, most severe in darker skin (38). The lesions recur on the same sites within a few hours on re-exposure to the drug, sometimes with new lesions at other sites (39).…”

Section: Clinical Phenotypesmentioning

confidence: 99%

Severe Delayed Cutaneous and Systemic Reactions to Drugs: A Global Perspective on the Science and Art of Current Practice

Peter

Lehloenya

Dlamini

et al. 2017

The Journal of Allergy and Clinical Immunology: In Practice

121

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The majority of immune-mediated adverse drug reactions (IM-ADRs) involve the skin, and many have additional systemic features. Severe cutaneous adverse drug reactions (SCAR) are an uncommon, potentially life-threatening and challenging sub-group of IM-ADRs with diverse clinical phenotypes, mechanisms and offending drugs. T-cell mediated immunopathology is central to these severe delayed reactions, but effector cells and cytokines differ by clinical phenotype. Strong HLA-gene associations have been elucidated for specific drug-SCAR IM-ADRs such as Stevens-Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN); although the mechanisms by which carriage of a specific HLA allele is necessary but not sufficient for the development of many IM-ADRs is still being defined. SCAR management is complicated by substantial short and long-term morbidity/ mortality and the potential need to treat ongoing co-morbid disease with related medications. Multidisciplinary specialist teams at experienced units should care for patients. In the setting of SCAR, patient outcomes as well as preventive,diagnostic, treatment and management approaches are often not generalizable, but rather context specific, driven by population HLA-genetics, the pharmacology and genetic risk factors of the implicated drug, severity of underlying co-morbid disease necessitating ongoing treatments, and cost considerations. In this review, we update the basic and clinical science of SCAR diagnosis and management.

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Section: Clinical Phenotypesmentioning

confidence: 99%

Severe Delayed Cutaneous and Systemic Reactions to Drugs: A Global Perspective on the Science and Art of Current Practice

Peter

Lehloenya

Dlamini

et al. 2017

The Journal of Allergy and Clinical Immunology: In Practice

121

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“…[3] It has been associated with certain drugs, namely mefenamic acid, naproxen, cetirizine, ciprofloxacin, doxycycline, and nicotinic acid/laropiprant. [4]…”

Section: Casementioning

confidence: 99%

Cyclosporine in generalized bullous-fixed drug eruption

et al. 2018

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“…It’s also characterized by a cell-poor infiltrate, where macrophages and dendrocytes with a strong TNF-α immunoreactivity predominate [6, 50]. …”

Section: Histologic Featuresmentioning

confidence: 99%

“…As described in Table 3, major differential diagnosis of EM and SJS/TEN are (1) staphylococcal scalded skin syndrome (SSSS), (2) autoimmune blistering diseases and disseminated fixed bullous drug eruption, (3) others severe delayed DHR [6, 70, 82] (4) Graft versus host disease SSSS is characterized by periorificial face scabs, de-epithelialization of friction zones and conspicuous desquamation after initial erythroderma. Trigger is an exotoxin released by Staphylococcus aureus [83].…”

Section: Diagnosis E Prognosismentioning

confidence: 99%

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Drug induced exfoliative dermatitis: state of the art

et al. 2016

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Drug induced exfoliative dermatitis (ED) are a group of rare and severe drug hypersensitivity reactions (DHR) involving skin and usually occurring from days to several weeks after drug exposure. Erythema multiforme (EM), Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the main clinical presentations of drug induced ED. Overall, T cells are the central player of these immune-mediated drug reactions. Here we provide a systematic review on frequency, risk factors, pathogenesis, clinical features and management of patients with drug induced ED.Electronic supplementary materialThe online version of this article (doi:10.1186/s12948-016-0045-0) contains supplementary material, which is available to authorized users.

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Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features

Cited by 99 publications

References 20 publications

Severe Delayed Cutaneous and Systemic Reactions to Drugs: A Global Perspective on the Science and Art of Current Practice

Severe Delayed Cutaneous and Systemic Reactions to Drugs: A Global Perspective on the Science and Art of Current Practice

Cyclosporine in generalized bullous-fixed drug eruption

Drug induced exfoliative dermatitis: state of the art

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