Beneficial Therapeutic Effect of Plasmapheresis After Unsuccessful Treatment With Corticosteroids in Two Patients With Severe Toxic Epidermal Necrolysis
Toxic epidermal necrolysis (TEN) is a rare, life‐threatening disease with a high mortality rate. It is linked to drug toxicity and characterized by epidermal necrolysis with mucositis and conjunctivitis. Treatment is not established due to the unknown pathogenesis and lack of randomized clinical tri...
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| Veröffentlicht in: | Therapeutic apheresis and dialysis 2010-06, Vol.14 (3), p.354-357 |
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| creator | Szczeklik, Wojciech Nowak, Ilona Seczynska, Bozena Sega, Aurelia Krolikowski, Wieslaw Musial, Jacek |
| description | Toxic epidermal necrolysis (TEN) is a rare, life‐threatening disease with a high mortality rate. It is linked to drug toxicity and characterized by epidermal necrolysis with mucositis and conjunctivitis. Treatment is not established due to the unknown pathogenesis and lack of randomized clinical trials. It is mostly based on withdrawal of the culprit drug and symptom‐related approach. The role of corticosteroids and plasmapheresis in the disease treatment remains controversial. We present two patients with severe TEN (both with >80% body skin surface involvement) treated unsuccessfully with corticosteroids followed by plasmapheresis. Plasmapheresis led to prompt improvement, with extensive reepithealization of the skin, and eventually total recovery of both patients. In severe TEN unresponsive to corticosteroids, treatment with plasmapheresis should be considered. |
| doi_str_mv | 10.1111/j.1744-9987.2009.00800.x |
| format | Article |
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It is linked to drug toxicity and characterized by epidermal necrolysis with mucositis and conjunctivitis. Treatment is not established due to the unknown pathogenesis and lack of randomized clinical trials. It is mostly based on withdrawal of the culprit drug and symptom‐related approach. The role of corticosteroids and plasmapheresis in the disease treatment remains controversial. We present two patients with severe TEN (both with >80% body skin surface involvement) treated unsuccessfully with corticosteroids followed by plasmapheresis. Plasmapheresis led to prompt improvement, with extensive reepithealization of the skin, and eventually total recovery of both patients. In severe TEN unresponsive to corticosteroids, treatment with plasmapheresis should be considered.</description><identifier>ISSN: 1744-9979</identifier><identifier>EISSN: 1744-9987</identifier><identifier>DOI: 10.1111/j.1744-9987.2009.00800.x</identifier><identifier>PMID: 20609191</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adult ; Corticosteroids ; Drug hypersensitivity ; Female ; Glucocorticoids - therapeutic use ; Humans ; Lyell's syndrome ; Plasmapheresis ; Plasmapheresis - methods ; Severity of Illness Index ; Stevens-Johnson Syndrome - physiopathology ; Stevens-Johnson Syndrome - therapy ; Toxic epidermal necrolysis ; Treatment Outcome ; Young Adult</subject><ispartof>Therapeutic apheresis and dialysis, 2010-06, Vol.14 (3), p.354-357</ispartof><rights>2010 The Authors. 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In severe TEN unresponsive to corticosteroids, treatment with plasmapheresis should be considered.</description><subject>Adult</subject><subject>Corticosteroids</subject><subject>Drug hypersensitivity</subject><subject>Female</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Lyell's syndrome</subject><subject>Plasmapheresis</subject><subject>Plasmapheresis - methods</subject><subject>Severity of Illness Index</subject><subject>Stevens-Johnson Syndrome - physiopathology</subject><subject>Stevens-Johnson Syndrome - therapy</subject><subject>Toxic epidermal necrolysis</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1744-9979</issn><issn>1744-9987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhSMEoj_wCsg7Vgm2k9iJxGYYOi2oKiORUsTGcuxr1UP-sBM68yY8Lg4pswVvfKX7nXOvfaIIEZyQcN7sEsKzLC7LgicU4zLBuMA42T-JTo-Np8ealyfRmfc7jCnN0vR5dEIxwyUpyWn06x10YKyyskHVPTg5wDRahS6MATWi3qBtI30rh9ADbz1amREcuu38pBR4b6agcyDHFroR3dnxHq17Fxx6H7jeao9sh6qHHm3laAPjF-gz_AyGqOr387DBanBtWOEGlOubQxj0InpmZOPh5eN9Ht1uLqr1VXz96fLDenUdq4wRHEtt6kIWtdY8NUTjguXMyCzsRjlOqVZY1bnO65xyXgPLJFBmjOJ1zXBmqE7Po9eL7-D6HxP4UbTWK2ga2UE_eRG-kBFOKPs3maYsK8u8CGSxkOEx3jswYnC2le4gCBZzgGIn5mzEnJOYAxR_AhT7IH31OGSqW9BH4d_EAvB2AR5sA4f_NhbVahuKII8XuQ357I9y6b4LxlOei7ubS7HZfN3y91--iY_pbzf3vRo</recordid><startdate>201006</startdate><enddate>201006</enddate><creator>Szczeklik, Wojciech</creator><creator>Nowak, Ilona</creator><creator>Seczynska, Bozena</creator><creator>Sega, Aurelia</creator><creator>Krolikowski, Wieslaw</creator><creator>Musial, Jacek</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>201006</creationdate><title>Beneficial Therapeutic Effect of Plasmapheresis After Unsuccessful Treatment With Corticosteroids in Two Patients With Severe Toxic Epidermal Necrolysis</title><author>Szczeklik, Wojciech ; Nowak, Ilona ; Seczynska, Bozena ; Sega, Aurelia ; Krolikowski, Wieslaw ; Musial, Jacek</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4610-adfb8a8bdd73f1d08656fa4cce27032dc0cb5d5b5277be64ae26ffc7bb604f2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Corticosteroids</topic><topic>Drug hypersensitivity</topic><topic>Female</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Lyell's syndrome</topic><topic>Plasmapheresis</topic><topic>Plasmapheresis - methods</topic><topic>Severity of Illness Index</topic><topic>Stevens-Johnson Syndrome - physiopathology</topic><topic>Stevens-Johnson Syndrome - therapy</topic><topic>Toxic epidermal necrolysis</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Szczeklik, Wojciech</creatorcontrib><creatorcontrib>Nowak, Ilona</creatorcontrib><creatorcontrib>Seczynska, Bozena</creatorcontrib><creatorcontrib>Sega, Aurelia</creatorcontrib><creatorcontrib>Krolikowski, Wieslaw</creatorcontrib><creatorcontrib>Musial, Jacek</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Therapeutic apheresis and dialysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Szczeklik, Wojciech</au><au>Nowak, Ilona</au><au>Seczynska, Bozena</au><au>Sega, Aurelia</au><au>Krolikowski, Wieslaw</au><au>Musial, Jacek</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Beneficial Therapeutic Effect of Plasmapheresis After Unsuccessful Treatment With Corticosteroids in Two Patients With Severe Toxic Epidermal Necrolysis</atitle><jtitle>Therapeutic apheresis and dialysis</jtitle><addtitle>Ther Apher Dial</addtitle><date>2010-06</date><risdate>2010</risdate><volume>14</volume><issue>3</issue><spage>354</spage><epage>357</epage><pages>354-357</pages><issn>1744-9979</issn><eissn>1744-9987</eissn><abstract>Toxic epidermal necrolysis (TEN) is a rare, life‐threatening disease with a high mortality rate. 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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Corticosteroids Drug hypersensitivity Female Glucocorticoids - therapeutic use Humans Lyell's syndrome Plasmapheresis Plasmapheresis - methods Severity of Illness Index Stevens-Johnson Syndrome - physiopathology Stevens-Johnson Syndrome - therapy Toxic epidermal necrolysis Treatment Outcome Young Adult |
| title | Beneficial Therapeutic Effect of Plasmapheresis After Unsuccessful Treatment With Corticosteroids in Two Patients With Severe Toxic Epidermal Necrolysis |
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