Stevens–Johnson syndrome associated with azithromycin followed by transient reactivation of herpes simplex virus infection

Aihara, Yukoh; Ito, Shuichi; Kobayashi, Y.; Aihara, Michiko

doi:10.1046/j.1398-9995.2003.00336.x

Cited by 30 publications

(24 citation statements)

References 2 publications

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“…Furthermore, Herpes simplex virus was recognized in several cases of SJS, especially in children [16]. Single case reports describe Lupus erythematodes [17] or reactivation of Herpes simplex under treatment with azithromycine as potential causes of SJS [18]. The occurrence of TEN in a patient with severe aplastic anaemia after allogeneic haematopoietic stem cell transplantation has also been reported [19].…”

Section: Epidemiologymentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens-Johnson syndrome

Harr

French

2010

Orphanet J Rare Dis

512

556

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Toxic epidermal necrolysis (TEN) and Stevens Johnson Syndrome (SJS) are severe adverse cutaneous drug reactions that predominantly involve the skin and mucous membranes. Both are rare, with TEN and SJS affecting approximately 1or 2/1,000,000 annually, and are considered medical emergencies as they are potentially fatal. They are characterized by mucocutaneous tenderness and typically hemorrhagic erosions, erythema and more or less severe epidermal detachment presenting as blisters and areas of denuded skin. Currently, TEN and SJS are considered to be two ends of a spectrum of severe epidermolytic adverse cutaneous drug reactions, differing only by their extent of skin detachment. Drugs are assumed or identified as the main cause of SJS/TEN in most cases, but Mycoplasma pneumoniae and Herpes simplex virus infections are well documented causes alongside rare cases in which the aetiology remains unknown. Several drugs are at "high" risk of inducing TEN/SJS including: Allopurinol, Trimethoprim-sulfamethoxazole and other sulfonamide-antibiotics, aminopenicillins, cephalosporins, quinolones, carbamazepine, phenytoin, phenobarbital and NSAID's of the oxicam-type. Genetic susceptibility to SJS and TEN is likely as exemplified by the strong association observed in Han Chinese between a genetic marker, the human leukocyte antigen HLA-B*1502, and SJS induced by carbamazepine. Diagnosis relies mainly on clinical signs together with the histological analysis of a skin biopsy showing typical full-thickness epidermal necrolysis due to extensive keratinocyte apoptosis. Differential diagnosis includes linear IgA dermatosis and paraneoplastic pemphigus, pemphigus vulgaris and bullous pemphigoid, acute generalized exanthematous pustulosis (AGEP), disseminated fixed bullous drug eruption and staphyloccocal scalded skin syndrome (SSSS). Due to the high risk of mortality, management of patients with SJS/TEN requires rapid diagnosis, evaluation of the prognosis using SCORTEN, identification and interruption of the culprit drug, specialized supportive care ideally in an intensive care unit, and consideration of immunomodulating agents such as high-dose intravenous immunoglobulin therapy. SJS and TEN are severe and life-threatening. The average reported mortality rate of SJS is 1-5%, and of TEN is 25-35%; it can be even higher in elderly patients and those with a large surface area of epidermal detachment. More than 50% of patients surviving TEN suffer from long-term sequelae of the disease.

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Section: Epidemiologymentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens-Johnson syndrome

Harr

French

2010

Orphanet J Rare Dis

512

556

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“…For unclear reasons, it was found that patients with human immune deficiency virus (HIV) have higher risk of developing SJS and TEN compared to un-infected people [7, 16–21]. Other infections such as Mycoplasma pneumoniae infections and herpes simplex viral infections were linked to SJS and TEN even without previous exposure to medications [22–27]. SJS and TEN are associated with certain HLA types [28–32].…”

Section: Introductionmentioning

confidence: 99%

Bibliometric analysis of literature on toxic epidermal necrolysis and Stevens-Johnson syndrome: 1940 – 2015

Sweileh

2017

Orphanet J Rare Dis

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BackgroundStevens Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but fatal adverse skin reactions that affect all age groups. In order to better understand literature on this topic, we conducted a bibliometric study using Scopus database to shed light on number and growth of publications, most active countries, institutions, journals and authors involved in publishing articles in this field, citation analysis, top cited articles, international collaboration, role of medications and genetic association. Bibliometric analysis will enrich the literature on these rare conditions and will provide baseline data for future comparison.ResultsThree thousand eight hundred fifty-six journal articles were retrieved. The h-index of retrieved documents was 95. Growth rates of publications were highest from 1966 to 1975 and from 2006 to 2015. The United States of America (n = 640; 16.57%) was the leading country in number of publications. However, French and Japanese researchers and institutions were most active in publishing articles on SJS and TEN. International collaboration among active countries was relatively low and ranges from 32.5% for Swiss researchers and 1.47% for Spanish researchers. The most frequently mentioned medication in retrieved articles was carbamazepine (n = 146) followed by phenytoin (n = 114) and allopurinol (n = 112). Mycoplasma infection was mentioned in 111 articles. Most documents on SJS and TEN were published in dermatology journals, specifically Archives of Dermatology. However, in the last decade, top cited articles appeared in dermatology and pharmacogenetic journals. Carbamazepine was frequently encountered with Han Chinese and HLA-B 1502 terms while allopurinol was frequently encountered with HLA-B 5801 and Japanese terms.ConclusionBibliometric analysis reveals that research publications on SJS and TEN have been increasing since the l940s, with relatively low international collaboration. Documents are being published, not only in dermatology journals, but also in genetic, public health and general medicine journals. Research on SJS and TEN can be helpful to clinicians and researchers not only to document complications and fatal outcomes, but also to identify potential causative agents and potential ethnic variations to note gaps in research.

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“…23,24 SJS has been tailored to viral and Mycoplasma pneumonia without previous sensitization. 19,[25][26][27][28][29][30] Studies in immunicompromized patients show that they are more susceptible to SJS. 18,[30][31][32][33][34][35] This suggests genetic inclination to the varying manifestations of SJS.…”

Section: Discussionmentioning

confidence: 99%

Anatomy, Physiology and Drugs Triangular Dynamics in Steven Johnsons Syndrome

2017

MOJAP

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The incidence of Steven-Johnson syndrome has been on the increase within the last two years in Nigeria. This renewed the interest on this disease to explore the dynamics for improved patient care. This review outlined the relationship between anatomic or structural changes, physiological variations, and the effect of drugs in Steven Johnson's syndrome. Better understanding of the fundamental structural and physiological changes in affected patients is vital to improve the treatment and/or the initial management procedures in resource-limited environments. This article showed the relationship between structural features, functions, and treatment. Tailoring treatment to the anatomical, physiological changes, and the effect of drugs and causative agents suggests a triangular dynamic trend in the disease state management.

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Stevens–Johnson syndrome associated with azithromycin followed by transient reactivation of herpes simplex virus infection

Cited by 30 publications

References 2 publications

Toxic epidermal necrolysis and Stevens-Johnson syndrome

Toxic epidermal necrolysis and Stevens-Johnson syndrome

Bibliometric analysis of literature on toxic epidermal necrolysis and Stevens-Johnson syndrome: 1940 – 2015

Anatomy, Physiology and Drugs Triangular Dynamics in Steven Johnsons Syndrome

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