Toxic epidermal necrolysis and intravenous immunoglobulin: a review.

Toxic epidermal necrolysis (TEN, Lyell's syndrome) is a rare, life-threatening hypersensitivity reaction to certain medications, such as sulfonamides, antibiotics, non-steroidal anti-inflammatory drugs, and anti-convulsants. The incidence of TEN is 0.4-1.

Community-acquired methicillin resistant Staphylococcus aureus skin infection.

Staphylococcus aureus is one of the most common pathogens in skin and soft tissue infections, as well as in potentially serious nosocomial infections in patients who acquire it when hospitalized. Penicillin was introduced in the 1940's as an effective treatment against S. aureus.

Use of intravenous immunoglobulin in toxic epidermal necrolysis and Stevens-Johnson syndrome: our current understanding.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN, Lyell's disease, syndrome) are considered to be part of a spectrum of adverse cutaneous drug reactions with increasing severity and extent of skin detachment, ranging from SJS (less than 10% body surface area skin detachment, 1-5% mortality) to TEN (greater than 30% skin detachment, 25-35% mortality). Both SJS and TEN are characterized morphologically by ongoing apoptotic keratinocyte cell death that results in the separation of the epidermis from the dermis. Recent evidence is supportive of a role for the death receptor Fas and its ligand FasL, in the pathogenesis of keratinocyte apoptosis during TEN.

Successful treatment of Von Zumbusch pustular psoriasis with infliximab.

Background: Von Zumbusch pustular psoriasis is a severe, generalized form of psoriasis. Patients may also suffer from systemic complications, such as fever, arthropathy, congestive heart failure, and infections, which can ultimately prove fatal. Generalized pustular psoriasis can often be recalcitrant, making treatment difficult.

Venous ulcers: pathophysiology and treatment options.

Venous ulcers affect approximately 1% of the world's population, increasing healthcare expenditures and decreasing quality of life. Several hypotheses may help explain their origin. Incompetent veins or valves or impaired muscle function may lead to abnormal calf muscle pump function that can elevate ambulatory venous pressure (venous hypertension).

Tumor necrosis factor alpha inhibitors for the treatment of dermatologic diseases.

Tumor necrosis factor alpha (TNFalpha) is involved in cell differentiation, mitogenesis, cytotoxic responses, inflammation, immunomodulation, and wound healing. Because of its numerous roles, it was thought that inhibition of TNF may aid in the treatment of certain dermatologic diseases such as psoriasis, hidradentitis suppurativa, pyoderma gangrenosum, Behcet 's syndrome, and graft versus host disease. The efficacy of these agents has proven impressive and short-term side effects have been few and relatively benign.

Cutaneous manifestations of HIV: a primer.

Purpose: To provide physicians and nurses with an overview of the characteristics and treatments for skin lesions associated with HIV/AIDS.

Target Audience: This continuing education activity is intended for physicians and nurses with an interest in identifying and managing skin lesions in patients with HIV/AIDS.

Objectives: After reading the article and taking the test, the participant will be able to: 1.

Mucoepidermoid carcinoma (adenosquamous carcinoma) treated with Mohs micrographic surgery.

Background: Mucoepidermoid carcinoma (MEC), sometimes referred to as adenosquamous carcinoma (ASC), is a common malignant tumor of the salivary glands that can also develop from the esophagus, lacrimal passages, lung, upper respiratory tract, pancreas, prostate and thyroid. Rarely, MEC will present primarily in the skin.

Case: We present a case of primary MEC of the lower eyelid treated successfully with Mohs micrographic surgery.

Hospitalization for severe skin disease improves quality of life in the United Kingdom and the United States: a comparative study.

Background: Financial and managerial constraints have resulted in the rationalization of dermatology inpatient services in the United Kingdom and the United States. Therapeutic regimes may vary locally, regionally, and internationally but the clinical outcome of treatment remains the same.

Objective: We studied 2 inpatient units: the University of Wales College of Medicine, Cardiff, United Kingdom, and the University of Miami School of Medicine, Miami, Florida, to compare the use and effectiveness of the service provided.

Identifying and treating mycotic skin infections.

Purpose: To provide physicians and nurses with an overview of mycotic infections and related cutaneous manifestations.

Target Audience: This continuing-education activity is intended for physicians and nurses with an interest in learning how to recognize and treat mycotic skin infections.

Objectives: After reading the article and taking the test, the participant will be able to:1.

Wounds and malignancy.

Due to the prevalence of skin cancers, health care practitioners involved with wound management are likely to encounter cutaneous malignancies as part of their practice. This article focuses on 2 ways in which malignancies and wounds are related: the malignant degeneration of chronic wounds into cancer and malignancies that present as chronic wounds. The most common scenario in which chronic wounds have been associated with the development of squamous cell carcinoma is in the presence of chronic osteomyelitis.

Analysis of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis using SCORTEN: The University of Miami Experience.

Background: Toxic epidermal necrolysis (TEN) is a rare, life-threatening condition caused by certain medications. Keratinocytes affected by TEN have been found to undergo apoptosis mediated by Fas-FasL interactions. Treatment with intravenous immunoglobulin (IVIG) has been proposed to inhibit this interaction.

Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases.

Objective: To evaluate the effect of high-dose intravenous immunoglobulin (IVIG) in toxic epidermal necrolysis (TEN), parameters that may affect response to treatment, and the effect of different IVIG batches on Fas-mediated cell death.

Design: Multicenter retrospective analysis of 48 consecutive TEN patients treated with IVIG.

Setting: Fourteen university hospital dermatology centers in Europe and the United States.