Toxic epidermal necrolysis after bone marrow transplantation: Study of nine cases

Pulmonary complications in toxic epidermal necrolysis: a prospective clinical study

“…The main drugs incriminated in T E N are antibacterial sulfonamides, anticonvulsants, some nonsteroidal anti-inflammatory agents, and allopurinol [4][5][6]. In a few cases, T E N has been demonstrated to be related to Mycoplasma infection [7] or graft-versus-host disease (GVH) [8]. T E N is characterized by extensive epidermal detachment with mucous membrane involvement (Fig.…”

The Association Between Carbamazepine and Valproate and Adverse Cutaneous Drug Reactions in Patients With Bipolar Disorder

“…4,[12][13][14] Other conditions are solely related to TEN such as bone marrow transplantation and graft-versushost disease. 15 Although the incidence of severe, potential life-threatening ACDR is fortunately low, these reactions can affect anyone who takes medication. Once the reactions become severe, the mortality rates are as high as 1% to 18% for SJS and 30% to 50% for TEN.…”

Cutaneous Graft-versus-Host Disease

“…4 Compared with classic toxic epidermal necrolysis, in which mortality is only 30%, the factors of poorer prognosis in grade IV GvHD are the increased risk of infection and the severe extracutaneous involvement. In addition, corticosteroids are not used in classic toxic epidermal necrolysis because their potential role in facilitating infection, hypercatabolism, and retardation of healing might contribute to a poorer outcome.…”

“…A group from France retrospectively analyzed 9 cases of grade IV acute GvHD; 4 of them had no extracutaneous involvement of GvHD and therefore theoretically appeared more like a drug reaction. 4 Also, some clinical pictures suggestive of GvHD could correspond to viral infections, particularly human herpesvirus 6. However, Horn et al 24 demonstrated in rodents that the presence of a dermal lymphocytic infiltrate was useful in distinguishing GvHD from preparative regimen toxicity.…”

“…In 6% of cases, epidermal necrosis occurs, which can remain localized to pressure sites or can spread (Figure 4). 4 In these cases, the Nikolsky sign is positive and skin flaps slough off. Acute GvHD may also present as a scarlatiniform rash with confluent sheets of erythema that desquamate and leave areas of hyperpigmentation, and it may even present as a clinical picture suggestive of varicella.…”