81. 5.4 ERYTHEMA MULTIFORME, STEVENS JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS Essential Drugs List Hospital Adult. 5.4. ERYTHEMA MULTIFORME, STEVENS JOHNSONSYNDROME, toxic epidermal necrolysis Treatment guidelines. Management, Comments. http://www.hst.org.za/pubs/edl/adult/5.4.asp

Essential Drugs List Hospital - Adult 5.4. ERYTHEMA MULTIFORME, STEVENS JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS Treatment guidelines Management Comments Non-drug treatment Supportive and symptomatic, Identify the offending agent and remove. Monitor vital organ function in severe cases Definition A continuum ranging from mild Erythema Multiforme (EM), to the moderate Stevens Johnson Syndrome (SJS), to the most severe and often lethal Toxic Epidermal Necrolysis (TEN). All cases should be referred Drug treatment Mild cases: Betamethasone 0.1% cream, apply daily PLUS Treat until the condition settles clinically Severe cases: Prednisone, oral, 60 mg daily for 3 days may be considered and can be used early. Topical antiseptic baths e.g. strong potassium permanganate and dressings with topical antiseptic and paraffin-impregnated dressings may be used. Systemic antibiotics, depending on results of culture on swabs, blood culture and urine culture. Repeated irrigation of oral mucosa and conjunctiva.

82. Toxic Epidermal Necrolysis toxic epidermal necrolysis. Definition Advances in toxic epidermal necrolysis. Seminars in Cutaneous Medicine and Surgery 15 (December 1996) 258266. http://www.chclibrary.org/micromed/00068540.html

Main Search Index Definition Description Causes ... Resources Toxic epidermal necrolysis Definition Toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis, the skin's outermost layer, to detach from the layers of skin below. A reaction to a medication is the primary cause. Description Toxic epidermal necrolysis (TEN) begins with fever cough , and other nonspecific symptoms, and is soon followed by purplish, bloody-looking lesions on the skin and mucous membranes. These early lesions, typically found on the head, neck, and upper chest, soon merge and blister. Sheets of epidermis then begin to detach from the skin layers below. In time, the entire surface of the skin may be involved, with detachment of 100% of the epidermis. The main cause of TEN is a severe drug reaction. Some investigators believe there may be additional infectious causes. A severe reaction in transplant patients, called graft-vs.-host disease, can also produce TEN. One study reported more than 100 different drugs as causes of TEN. The drugs most commonly implicated, however, include antibacterial sulfonamides such as sulfadiazine

83. Toxic Epidermal Necrolysis toxic epidermal necrolysis. This kind of drug eruption is the mostsevere kind. We wish you to early recognize or avoid this kind http://www.thai-skin-clinic.com/toxic.htm

Toxic epidermal necrolysis T his kind of drug eruption is the most severe kind. We wish you to early recognize or avoid this kind of drug eruption since it can kill patient or at least leave bad side effects such as blindness for the patients. The following list is the names of drugs reported to cause this killer drug eruption. Antibiotics: ampicillin, chloramphenicol, erythromycin, neomycin, penicillin G, penicillin V, procaine-penicillin, tetracycline, streptomycin, sulfonamides, sulfadiazine, sulfadimethoxine, sulfadoxine, sulfamethoxazole with trimethoprim, sulfamethoxypyridazine, sulfamethoxydiazine, sulfasalazine, sulfathiazole, sulfisoxazole. Anti-infectious agents: benznidazole, chloroquine, dapsone, isoniazid, nitrofurantoin, pyrimethamine with sulfadoxine, quinine, tetrachloroethylene, thiabendazole, thioacetazole. Analgesics, Antipyretics, Antirheumatics:

84. ELibrary.com - The Mosby Medical Encyclopedia 10-01-1996, 'toxic eLibrary is the subscription based online library for fun or research. Find out more about securing your guaranteed Free 7day trial with your credit card and retrieve 'eLibrary.com - The Mosby Medical Encyclopedia 10-01-1996, 'toxic epidermal http://redirect-west.inktomi.com/click?u=http://ask.elibrary.com/getdoc.asp%3Fpu

85. New Treatment For Acute Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis New Treatment for Acute StevensJohnson Syndrome and toxic epidermalNecrolysis Stevens-Johnson syndrome (SJS) and toxic epidermal http://www.aao.org/aao/education/library/memberalert/stevens_johnson.cfm

help Last Name ID Number AAO Home Online Education Center Library Member Alerts and Updates New Treatment for Acute Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are moderate and severe variations of the same adverse reaction (usually to drugs or mycoplasma pneumonia) which result in blistering and sloughing of skin and mucosal membranes, and carry a high risk of mortality. With the seemingly unstoppable acute phase often lasting several weeks, SJS and TEN have always been a challenge to treat. Despite round-the-clock application of lubricant ointments, antibiotic and steroid drops, and daily lysis of adhesions using a glass rod, the majority of patients still end up with a lifetime of ocular problems. These sequelae range from mild dry eye, ongoing inflammation, scarred eyelids, entropion with trichiasis, photophobia, and decreased vision, to chronic corneal ulcers, corneal vascularization, total limbal deficiency, complete loss of tears, significant vision loss or blindness, constant severe pain, or complete loss of one or both eyes. Now, a treatment appears to not only help bring a halt to the ocular reaction, but could prevent all or most of these sequelae from developing. This treatment involves the application of amniotic membrane to all eye and inner lid surfaces as soon as possible during the acute phase.

86. Abstracts W, Schöpf E. Incidence of StevensJohnson syndrome (SJS) and toxic epidermalnecrolysis (TEN) in West-Germany and Berlin among different ethnic groups. http://www.ukl.uni-freiburg.de/haut/dzh/abstrace.htm

Abstracts Baur S, Rzany B, Mockenhaupt M, Holländer N, Stocker U, Mueller J, Schröder W, Schöpf E. Incidence of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in West-Germany and Berlin among different ethnic groups. J Invest Dermatol 102: 619 (1994). Mockenhaupt M, Hamouda O, Stocker U, Holländer N, Körner M, Baur S, Rzany B, Schöpf E. Incidence of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in AIDS patients in Germany. Journal of Investigative Dermatology 100: 542 (1993). Mockenhaupt M, Rzany B, Baur S, Mueller J, Schröder W, Stocker U, Zobel K, Holländer N, Schöpf E. Drug risk for Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN): Evaluation of antiepileptics based on sale numbers in defined daily doses (DDD). Pharmacoepidemiology and Drug Safety 3: 22 (1994). Mockenhaupt M, Schröder W, Höchstetter R, Rzany B, Schöpf E. Drug attributability in HIV-infected patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Pharmacoepidemiology and Drug Safety 4: 54 (1995).

87. Erythema Multiforme Alternative Names Lyell's syndrome; StevensJohnson syndrome; Toxicepidermal necrolysis. Causes, incidence, and risk factors Erythema http://www.pennhealth.com/ency/article/000851.htm

Disease Injury Nutrition Poison ... Prevention Erythema multiforme Definition: Erythema multiforme is a skin disorder resulting from an allergic reaction Alternative Names: Lyell's syndrome; Stevens-Johnson syndrome; Toxic epidermal necrolysis Causes, incidence, and risk factors: Erythema multiforme is a type of hypersensitivity (allergic) reaction that occurs in response to medications, infections, or illness. Medications associated with erythema multiforme include sulfonamides, penicillins, barbiturates, and phenytoin. Associated infections include herpes simplex and mycoplasma infections. The exact cause is unknown. The disorder is believed to involve damage to the blood vessels of the skin with subsequent damage to skin tissues. Approximately 90% of erythema multiforme cases are associated with herpes simplex or Mycoplasma infections. The disorder occurs primarily in children and young adults. Erythema multiforme may present with a classic skin lesion with or without systemic (whole body) symptoms. In Stevens-Johnson syndrome, the systemic symptoms are severe and the lesions are extensive, involving multiple body areas (especially the mucous membranes). Toxic epidermal necrolysis (TEN syndrome, or Lyell's syndrome) involves multiple large blisters bullae ) that coalesce, followed by sloughing of all or most of the skin and mucous membranes.

88. The Troxel Tens Foundation - Funding Research Into Toxic Epidermal Necrolysis Sy http://www.tensfoundation.org/

89. Treatment Of Severe Drug Reactions: Stevens-Johnson Syndrome, Toxic Epidermal Ne Treatment of severe drug reactions StevensJohnson Syndrome, toxic EpidermalNecrolysis and Hypersensitivity syndrome Pierre-Dominique Ghislain MD, Jean http://dermatology.cdlib.org/DOJvol8num1/reviews/drugrxn/ghislain.html

DOJ Contents Treatment of severe drug reactions: Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis and Hypersensitivity syndrome Pierre-Dominique Ghislain M.D., Jean-Claude Roujeau, M.D. Dermatology Online Journal 8(1): 5 Department of Dermatology, H6pital Henri Mondor, Universit6 Paris XII, Cr6teil, France Abstract Severe skin adverse drug reactions can result in death. Toxic epidermal necrolysis (TEN) has the highest mortality (30-35%); Stevens-Johnson syndrome and transitional forms correspond to the same syndrome, but with less extensive skin detachment and a lower mortality (5-15%). Hypersensitivity syndrome, sometimes called Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), has a mortality rate evaluated at about 10%. Drug reactions are self-limited diseases and therefore, generally treatment is symptomatic. Prompt diagnosis, identification of, and early withdrawal of all suspect drugs are the most important preliminaries. The management of the patients must be undertaken in specialized intensive care units, with the same main types of therapy as for burns: warming of the enviromnent, correction of electrolyte disturbances, administration of a high caloric enteral intake, and prevention of sepsis. Efficacy of drugs used in some case reports is difficult to evaluate: intravenous immunoglobulins, cyclosporin, cyclophosphamide, pentoxyfilline, and thalidomide have all been tried. Corticosteroid use is debated and is probably deleterious in late forms of TEN. For DRESS, corticoids are used in cases of life-threatening systemic impairment. Specific nursing care and adequate topical management reduce associated morbidity and allow a more rapid re-epithelialization of skin lesions.

90. La Dermatología - La Necrólisis Epidérmica Tóxica (Dermatology - Toxic Epide Translate this page La Dermatología La Necrólisis Epidérmica Tóxica. ¿Qué es la necrólisisepidérmica tóxica? La necrólisis epidérmica tóxica http://www.mmhs.com/clinical/peds/spanish/derm/necrolys.htm

English - Adult English - Pediatric Spanish - Adult Spanish - Pediatric La Dermatología La Necrólisis Epidérmica Tóxica ¿Qué es la necrólisis epidérmica tóxica? La necrólisis epidérmica tóxica es un desorden de la piel que pone en peligro la vida y se caracteriza por la formación de ampollas y la exfoliación de la piel. Puede ser provocado por la reacción a un fármaco, frecuentemente antibióticos o anticonvulsionantes. Aproximadamente en un tercio de los casos de necrólisis epidérmica tóxica, no es posible identificar la causa. ¿Cuáles son los síntomas de necrólisis epidérmica tóxica? La necrólisis epidérmica tóxica provoca el desprendimiento de la piel en láminas, lo cual deja zonas extensas de la piel en carne viva. La pérdida de piel permite la supuración de fluidos y sales en las zonas dañadas, que pueden infectarse fácilmente. A continuación, se enumeran los síntomas más comunes de la necrólisis epidérmica tóxica. Sin embargo, cada niño puede experimentarlos de una forma diferente. Los síntomas pueden incluir: Presencia de una zona roja y dolorosa que se extiende con rapidez.

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