Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening spectrum diseases in which a medication triggers a mucocutaneous reaction associated with severe necrosis and loss of epidermal integrity. The disease has a high mortality rate that can be assessed by dermatology scoring scales based on an affected total body surface area (TBSA). Sloughing of <10% TBSA is considered SJS, with a mortality of 10%. Sloughing of >30% TBSA is termed TEN, with an increased mortality rate of 25% to 35%. We present a case and management of TEN that involved >30% TBSA in a critically ill African American woman. Identification of the offending agent was difficult due to complicated medication exposure throughout her multi-facility care management. This case conveys the importance of close monitoring of a critically ill patient during a clinical course involving SJS-/TEN-inducing drugs. We also discuss the potential increased risks for SJS/TEN in the African American population due to genetic or epigenetic predispositions to skin conditions. This case report also contributes to increasing skin of color representation in the current literature. Additionally, we discuss the use of Chat Generative Pre-trained Transformer (ChatGPT, OpenAI LP, OpenAI Inc., San Francisco, CA, USA) and list its benefits and errors.
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http://dx.doi.org/10.7759/cureus.35742 | DOI Listing |
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January 2025
Department of Radiology, School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia.
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Department of Emergency Medicine and Pre-Hospital Services, St. Olav's University Hospital, Trondheim, Norway.
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View Article and Find Full Text PDFBMC Psychiatry
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Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
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Department of Critical Care Medicine, West China Hospital, Sichuan University, 37 Guo Xue Xiang St, Chengdu, 610041, Sichuan, China.
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Zhonghua Nei Ke Za Zhi
February 2025
Department of Critical Care Medicine, the First Hospital of Tsinghua University, Beijing100016, China.
Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor's professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China.
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