Version 1
: Received: 17 October 2022 / Approved: 19 October 2022 / Online: 19 October 2022 (07:28:11 CEST)
How to cite:
Garg, V.K. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis- An Overview. Preprints2022, 2022100270. https://doi.org/10.20944/preprints202210.0270.v1
Garg, V.K. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis- An Overview. Preprints 2022, 2022100270. https://doi.org/10.20944/preprints202210.0270.v1
Garg, V.K. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis- An Overview. Preprints2022, 2022100270. https://doi.org/10.20944/preprints202210.0270.v1
APA Style
Garg, V.K. (2022). Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis- An Overview. Preprints. https://doi.org/10.20944/preprints202210.0270.v1
Chicago/Turabian Style
Garg, V.K. 2022 "Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis- An Overview" Preprints. https://doi.org/10.20944/preprints202210.0270.v1
Abstract
Both Stevens Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are main injurious cutaneous medication reactions that mostly affect the epidermis and mucus membranes. TEN and SJS affecting nearly 1 or 2/1,000,000 people per year, and can recognized as medical crises since they may be deadly. Mucocutaneous discomfort, hemorrhagic erosions, erythema, and more or less severe epidermal separation that appear as ulcer and patches of dermic loss are their defining characteristics. The sole difference between TEN and SJS at this time is the degree of skin detachment, making them two extremes of a spectrum of severe cutaneous adverse drug reactions (cADRs). In the majority of cases, drugs are considered as the principal reason of SJS/TEN, but herpes simplex virus and Mycoplasma pneumoniae infections are also recognized causes, along with lesser number of cases in which the cause is still unknown. Among the drugs with a "high" likelihood of producing TEN/SJS are carbamazepine (CBZ), trimethoprim-sulfamethoxazole, phenytoin, aminopenicillins, allopurinol, cephalosporins, other sulfonamide antibiotics, quinolones, phenobarbital, and NSAIDs of the oxicam variety. There is strong genetic evidence for SJS and TEN in Han Chinese due to the substantial association between the human leukocyte antigen (HLA-B*1502) and SJS brought on by CBZ. The diagnosis is made mostly based on clinical symptoms and the histological study of a dermal biopsy. Pemphigus vulgaris, bullous pemphigoid, linear IgA dermatosis, paraneoplastic pemphigus, disseminated fixed bullous drug eruption, acute generalized exanthematous pustulosis (AGEP), and staphylococcal scalded skin syndrome (SSSS) are among the differential diagnoses. The management of patients with SJS/TEN is complicated by the high risk of mortality, necessitating early diagnosis, estimation of the SCORTEN prognosis, identification and discontinuation of the causative drug, specialized supportive care, and high-dose injectable Ig therapeutic interventions. The reported fatality rates for SJS are 1-5% on average and 25-35% for TEN; it can be even higher in patients who are elderly or who have a significant amount of epidermal detachment on their skin. More than 50% of TEN patients who survive the disease experience long-term consequences.
Keywords
SJS; TEN; Adverse drug reactions
Subject
Biology and Life Sciences, Immunology and Microbiology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
