Publications by authors named "Mockenhaupt M"

Article Synopsis
  • Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are severe, drug-induced skin conditions that can be life-threatening and are now viewed as different levels of the same disease known as epidermal necrolysis (EN).
  • A new guideline has been created based on scientific literature and expert consensus to help medical professionals in diagnosing and treating EN.
  • This guideline targets various specialists like dermatologists and intensive care doctors, as well as informing patients, families, insurers, and policymakers about EN and includes recommendations for acute care and follow-up treatment.
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Article Synopsis
  • Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious, mostly drug-related conditions that affect the skin and mucous membranes, categorized under the umbrella term epidermal necrolysis (EN), which varies in severity.* -
  • A new guideline for diagnosing and treating SJS/TEN was created based on extensive scientific research and consensus among experts, involving various medical specialties to provide a comprehensive approach to patient care.* -
  • The guideline is designed for healthcare professionals across multiple fields, as well as patients, their families, insurers, and policymakers, with the first part specifically addressing diagnosis, initial treatment, and systemic immunotherapy.*
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Article Synopsis
  • Cutaneous adverse drug reactions include delayed reactions like morbilliform drug eruptions, which can improve over time, and severe cutaneous adverse reactions (SCARs), which require lifelong avoidance due to their lasting immunity and serious health risks.
  • SCARs are linked to multiple drug interactions and include conditions like Stevens-Johnson syndrome and toxic epidermal necrolysis, contributing to high rates of morbidity and mortality.
  • Current diagnostic tests for SCARs, including skin testing and HLA typing, lack 100% negative predictive value, leading to ongoing debates about the effectiveness of delayed skin testing in diagnosing these reactions.
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Article Synopsis
  • A 21-year-old female presented with symptoms like fever, sore throat, swollen lymph nodes, and a widespread rash, alongside a history of depression and recent bipolar disorder treatment.
  • Lab tests indicated elevated liver enzymes, eosinophilia, and other inflammatory markers, leading to a liver biopsy that suggested drug-induced hepatitis.
  • The diagnosis of DRESS (drug reaction with eosinophilia and systemic symptoms) was confirmed, requiring immediate cessation of the suspected medication and treatment with high-dose corticosteroids for recovery.
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Article Synopsis
  • Severe cutaneous adverse reactions (SCARs) are life-threatening conditions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, caused by immune reactions to drugs.
  • The development of SCARs is influenced by genetic factors, drug metabolism, and immune responses, leading to potential genetic screening before prescribing certain medications.
  • Treatment is evolving from traditional corticosteroids to precision therapies involving biologics and targeted small molecules, tailoring approaches based on individual patient profiles.
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BackgroundShortly after the launch of a novel adjuvanted recombinant zoster vaccine (RZV), Shingrix, cases of suspected herpes zoster (HZ) or zoster-like skin reactions following immunisation were reported.AimWe aimed to investigate if these skin manifestations after administration of RZV could be HZ.MethodsBetween April and October 2020, general practitioners (GP) reporting a suspected case of HZ or zoster-like skin manifestation after RZV vaccination to the Paul-Ehrlich-Institut, the German national competent authority, were invited to participate in the study.

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Article Synopsis
  • - SJS/TEN is a severe, drug-induced skin condition with a high mortality rate of 15-20% and requires multidisciplinary expertise for effective treatment; it's rare, with an incidence of 1-5 cases per million annually in the U.S., but more common globally.
  • - The SJS/TEN 2021 research meeting, held virtually, aimed to build an international research network involving 428 scientists and 140 survivors and family members to enhance collaboration between science and the community.
  • - The workshop covered vital themes such as mental health, pediatric cases, long-term complications, skin care for diverse populations, and the impact of COVID-19 vaccines, identifying key areas for future research and clinical focus.
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Generalized bullous fixed drug eruption (GBFDE) is the most severe form of fixed drug eruption and can be misdiagnosed as epidermal necrolysis (EN). We report the case of a 42-year-old male patient presenting with more than 50% skin detachment without defined areas of exanthema or erythema and a history of one prior event of EN caused by acetaminophen (paracetamol), allopurinol, or amoxicillin 1.5 years ago.

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Severe cutaneous drug reactions also occur in children and range from reactions with blister forming of skin and mucosa to extensive exanthems with altered differential blood count and involvement of internal organs. The first group includes Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are considered as one disease entity with different degrees of severity and are also referred to as "epidermal" or "epithelial necrolysis" (EN). The group of drug reactions with primarily systemic alterations is represented by a condition known as drug reaction with eosinophilia and systemic symptoms (DRESS).

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Objective: This study was undertaken to determine the impact of dosage in new users of lamotrigine (LTG) and the concomitant intake of valproic acid (VPA) on epidermal necrolysis (EN).

Methods: A total of 102 EN cases with exposure to LTG were identified (1992-2018) in the German Registry of Severe Skin Reactions. All cases are validated by an independent expert committee.

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Severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome, toxic epidermal necrolysis (SJS/TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS) cause significant morbidity and mortality and impede new drug development. HLA class I associations with SJS/TEN and drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome have aided preventive efforts and provided insights into immunopathogenesis. In SJS/TEN, HLA class I-restricted oligoclonal CD8 T-cell responses occur at the tissue level.

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Objective: Since April 2022, increasing numbers of monkeypox (MPX) cases have been reported outside endemic areas as part of an international outbreak. Our study shows aspects of clinical manifestations as well as epidemiological and virological features impacting transmission, for which only scarce data are available so far.

Methods: We present a descriptive study consisting of epidemiological, clinical and virological data of four patients with confirmed MPX diagnosis.

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Article Synopsis
  • Stevens-Johnson syndrome and toxic epidermal necrolysis are severe skin reactions often triggered by drugs, categorized together as epidermal necrolysis due to their similar causes and differing degrees of skin damage.
  • A study analyzing 4,150 case notifications revealed specific immuno-oncology drugs like vemurafenib and pembrolizumab can lead to these reactions, alongside other drugs like allopurinol.
  • Accurate diagnosis is crucial for treatment decisions; while re-exposure to drugs causing epidermal necrolysis is unsafe, it may be considered for other drug eruptions after careful evaluation.
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Introduction: Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening, neutrophilic, autoinflammatory skin disease characterised by recurrent flares of generalised sterile pustules and associated systemic features. Inconsistent diagnostic criteria and a lack of approved therapies pose serious challenges to GPP management. Our objectives were to discuss the challenges encountered in the care of patients with GPP and identify healthcare provider (HCP) educational needs and clinical practice gaps in GPP management.

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Allergy or hypersensitivity to drugs often affects the skin and sometimes also mucosa. While immediate type reactions show a rather homogeneous pattern, delayed type reactions reveal a high variability. In both cases it may not always be easy to differentiate drug reactions from non-drug-induced skin conditions.

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe and often life-threatening reactions of the skin and mucous membranes. They are considered as a single disease entity with different expressions of severity and are summarized under the term epidermal necrolysis (EN). There is a high risk of ocular involvement, which can lead to long-lasting eye problems and even blindness without immediate ophthalmological treatment.

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