Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered to be among the most severe dermatologic emergencies with high risk for morbidity and mortality if managed poorly. These disease processes usually are the result of a reaction to antipsychotic or antibiotic medications, though the complete list of potential causative drugs is extensive. Despite the life-threatening nature of these conditions, studies evaluating systemic immunomodulating agents that would be effective in halting the poor overall outcome are limited. Over the last several years, reports advocating the benefits of cyclosporine, corticosteroids, and intravenous immunoglobulin (IVIG) have shown variable responses in their treatment of SJS/TEN. In this article, cyclosporine and its potential as an emerging therapeutic option for SJS/TEN patients is discussed.
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Cyclosporin for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN): a systematic review of observational studies and clinical trials focusing on single therapy, combination therapy, and comparative assessments.
Inflammopharmacology
October 2024
Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Hospital, Niayesh Street, Sattar Khan Avenue, Tehran, 1445613131, Iran.
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, severe, and potentially life-threatening skin and mucous membrane disorders. They are characterized by widespread skin and mucosal detachment and necrosis, and are classified based on the percentage of total body surface area (TBSA) affected. Given the severe and often life-threatening nature of these conditions, the identification and implementation of effective treatments is crucial.
View Article and Find Full Text PDF[Deflazacort-induced Steven-Johnson syndrome: a case report and literature review].
Zhonghua Er Ke Za Zhi
November 2024
Department of Rheumatology & Clinical Immunology, Tianjin Children's Hospital, Tianjin 300134, China.
Article Synopsis
- The study aimed to highlight the clinical features and outcomes of Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) caused by deflazacort, particularly for patients with Duchenne muscular dystrophy (DMD) and healthcare professionals.
- A 12-year-old boy with DMD developed SJS after switching from prednisolone to deflazacort, presenting with severe skin and mucosal symptoms.
- Treatment included intravenous immunoglobulin (IVIG) and corticosteroids, leading to complete remission, and a literature review revealed a total of 7 male patients reported with similar conditions related to deflazacort.
Stevens-Johnson syndrome and toxic epidermal necrolysis: Updates in pathophysiology and management.
Chin Med J (Engl)
October 2024
Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Article Synopsis
- - Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious skin conditions with high mortality rates characterized by skin and mucous membrane detachment, but their causes and best treatments are still unclear.
- - Early diagnosis is difficult, and while some drugs are linked to SJS/TEN, HLA screening may help reduce risk, with new biomarkers identified for diagnosis and prognosis.
- - Treatment typically involves supportive care, but the effectiveness of various therapies like corticosteroids and immunoglobulin is debated, with recent studies examining the role of TNF-α antagonists in management.
Acute and chronic ocular outcomes in SJS/TEN patients treated with oral ciclosporin vs intravenous immunoglobulin.
Front Med (Lausanne)
August 2024
Corneal and External Diseases Department, Singapore National Eye Centre, Singapore, Singapore.
Article Synopsis
- - This study aimed to compare the ocular complications in patients with Stevens Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) treated with either systemic IVIG or Ciclosporin (CsA) from 2011 to 2017.
- - A total of 18 patients were analyzed; while the acute ocular severity was similar for both treatment groups, those receiving CsA showed a trend towards worse chronic complications and a higher incidence of severe corneal involvement compared to the IVIG group.
- - The findings suggest that CsA may lead to worse ocular outcomes in SJS/TEN patients than IVIG, but further research with larger sample sizes is needed to validate these results.
Evaluation of the Factors Influencing Mortality in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Multicenter Study of 166 Patients.
Dermatol Ther (Heidelb)
June 2024
Department of Dermatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Introduction: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening acute mucocutaneous disorders usually triggered by drugs. In this study, we aimed to evaluate the factors affecting mortality in patients with SJS-TEN.
Methods: Our study is a retrospective cohort study, analyzing data collected from a total of 12 tertiary care centers between April 2012 and April 2022.
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