Psychological sequelae of toxic epidermal necrolysis: further insights

Walsh, Sarah; Lew, T.; Lee, Haur Yueh

doi:10.1111/bjd.14831

Cited by 2 publications

(3 citation statements)

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“…Many experts in the area have highlighted the importance of managing, researching and preventing the psychological sequelae in patients with SJS and TEN. 13,16,25,43 Although some evidence exists, more clarity and research are required regarding the impacts on individuals' lives. 25 Eckert et al, 44 in a meeting abstract, have documented the importance of HCPs putting strategies (not identified) in place to prevent possible psychological sequelae such as PTSD in patients with SJS and TEN.…”

Section: Discussionmentioning

confidence: 99%

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The psychological impact of Stevens–Johnson syndrome and toxic epidermal necrolysis on patients’ lives: a Critically Appraised Topic*

et al. 2020

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Summary Clinical scenario A 65‐year‐old man presented with a 12‐h history of deteriorating rash. Two weeks previously he had completed a course of neoadjuvant chemotherapy for ductal carcinoma of the breast. On examination there were bullae, widespread atypical targetoid lesions and 15% epidermal detachment. There was no mucosal involvement on presentation, but subsequently it did evolve. Skin biopsy showed subepidermal blistering with epidermal necrosis. This confirmed our clinical diagnosis of overlap Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). On transfer to intensive care he was anxious and fearful. Management question What are the psychological impacts of SJS/TEN on this man's life? Background SJS and TEN have devastating outcomes for those affected. Objectives To conduct a Critically Appraised Topic to (i) analyse existing research related to the psychological impact of SJS and TEN and (ii) apply the results to the clinical scenario. Methods Seven electronic databases were searched for publications focusing on the psychological impact of SJS/TEN on adults over 18 years of age. Results Six studies met the inclusion criteria. Healthcare practitioners’ (HCPs’) lack of information around the disorder was highlighted. Patients experienced undue stress and fear. Some patients had symptoms aligned to post‐traumatic stress disorder (PTSD), anxiety and depression. Discussion and recommendation The evidence suggests that SJS and TEN impact psychologically on patients’ lives. Education of HCPs, to address their lack of awareness and information on SJS/TEN, should facilitate their capacity to provide information and support to patients, thereby reducing patient anxiety. On discharge, a follow‐up appointment with relevant HCPs to reduce the possibility of PTSD occurring should be considered.

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Section: Discussionmentioning

confidence: 99%

“…Many experts in the area have highlighted the importance of managing, researching and preventing the psychological sequelae in patients with SJS and TEN 13‐43. Although some evidence exists, more clarity and research are required regarding the impacts on individuals’ lives 25.…”

Section: Discussionmentioning

confidence: 99%

The psychological impact of Stevens–Johnson syndrome and toxic epidermal necrolysis on patients’ lives: a Critically Appraised Topic*

et al. 2020

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“…Limitations to the study included the use of one clinical site and a small number of patient participants. There are difficulties in researching rare conditions, but Walsh et al 9 advise that this should not deter researchers and HCPs to engage in follow-up discussions with patients to find out more about the psychological consequences of SJS/TEN. Given the psychological impact on patients' lives, there is a need to prioritize research in this area.…”

Section: Recommendations To Improve Patient Outcomesmentioning

confidence: 99%