Purpose: To clarify the importance of administering topical steroids for the treatment of Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) with ocular involvement in the acute phase.
Design: Retrospective case series.
Methods: Using the medical records of acute SJS/TEN patients treated at the Kyoto Prefectural University of Medicine Hospital, Kyoto, Japan, between July 2006 and July 2017, the ocular findings, topical steroid dosage, systemic steroid dosage, and ocular sequelae were retrospectively examined. The level of cytokines in tear fluid and serum samples was also analyzed.
Results: This study involved 13 cases. In 10 cases in whom the clinical courses were recorded before the start of steroid therapy, the mean acute ocular severity score (AOSS: 3 = very severe; 2 = severe; 1 = mild; 0 = none) was 2.8 ± 0.4 points in the severest phase. The mean systemic steroid dose after steroid pulse therapy was 694 ± 386 mg and the mean topical steroid (0.1% betamethasone eye drop and ointment) dose was 13.4 ± 3.3 times daily in the severest phase. Analysis of cytokine levels of 4 cases showed that a cytokine storm occurred in the tear fluid after the steroid pulse therapy. At final follow-up, 16 eyes of 8 patients had a logMAR visual acuity of ≤0, and no serious ocular sequelae were observed.
Conclusions: In patients with SJS/TEN, ocular surface inflammation remains strong even after systemic inflammation has improved post steroid pulse therapy, thus suggesting that both systemic and topical steroid therapy should be administered appropriately.
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http://dx.doi.org/10.1016/j.ajo.2023.05.010 | DOI Listing |
Acta Derm Venereol
January 2025
Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden.
Topical steroid withdrawal (TSW) is described as an adverse reaction to topical glucocorticoids (TGCs). A pathophysiological mechanism has not been identified. There are no diagnostic criteria.
View Article and Find Full Text PDFIntroduction: Nivolumab can cause various immune-related adverse events; it rarely induces Vogt-Koyanagi-Harada-disease-like uveitis. Vogt-Koyanagi-Harada-disease is reported to be closely associated with human leukocyte antigen-DR4.
Case Presentation: A 68-year-old man with metastatic renal cancer underwent nephrectomy.
J Steroid Biochem Mol Biol
December 2024
Department of Applied Chemistry and Chemical Engineering, Islamic University, Kushtia 7003, Bangladesh; Institute of Glass and Ceramic Research and Testing (IGCRT), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhaka 1205, Bangladesh.
Phthalates are a wide family of chemicals that are used in many different industrial applications used in many different industrial applications, including the production of plastics, toys, food packaging particularly for kids, and medical equipment. Due to their various chemical and physical properties, phthalates may negatively impact humans, animals, and the environment. Thus the potential for phthalate exposure and harm to humans, animals, and the environment is high because its presence is alarming.
View Article and Find Full Text PDFAm J Gastroenterol
January 2025
Kennth C. Griffin Esophageal Center, Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Acta Gastroenterol Belg
January 2025
Pediatric gastroenterology, Ghent university hospital, Ghent, Belgium.
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