Toxic Epidermal Necrolysis, Problems of Diagnosis and Therapy

Articles

A.S. Pоvzun1 , K.M. Krylov1 , P.K. Krylov1 , I.B. Furman1 , I.E. Belousova2 , K.E. Michunskii1 , O.V. Orlova1

Dzhanelidze St. Petersburg Research Institute of Emergency Medicine, Saint Petersburg, Russia

Military Medical Academy, Saint Petersburg, Russia

For correspondence: Olga V. Orlova — Candidate of Medical Science, senior researcher of the Department of burn injury Dzhanelidze St. Petersburg Research Institute of Emergency Medicine, Saint Petersburg, Russia; e-mail: olgaviktes@yandex.ru

For citation: Pоvzun AS, Krylov KM, Krylov PK, Furman IB, Belousova IE, Michunskii KE, Orlova OV. Toxic Epidermal Necrolysis, Problems of Diagnosis and Therapy. Intensive Care Herald. 2017;2:69–75. DOI:10.21320/1818-474X-2017-2-69-75


The review discusses modern ideas about the etiology, pathogenesis, diagnosis and treatment of toxic epidermal necrolysis (TEN) is a potentially life-threatening muco-cutaneous reactions. Given a description of two clinical cases.

Keywords: toxic epidermal necrolysis, Stevens—Johnson syndrome, Lyell’s syndrome, apoptosis of keratinocytes, granulysin, health and economic standard

Received: 22.12.2016

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References

  1. Григорьев Д.В. Многоформная экссудативная эритема, синдром Стивенса—Джонсона и синдром Лайелла — современная трактовка проблемы. РМЖ. 2013; 22: 1073–1083. [Grigor’ev D.V. Mnogoformnaya ekssudativnaya eritema, sindrom Stivensa—Dzhonsona i sindrom Laiella — sovremennaya traktovka problemy. RMJ. 2013; 22: 1073–1083. (In Russ)]
  2. Katsambas D., Lotti T.M. European Handbook of Dermatological Treatments. Moscow: MEDpress-inform, 2008.
  3. Lissia M. Toxic epidermal necrolysis (Lyell’s disease). Burns. 2010; 36: doi: 10.1016/j.burns.2009.06.213.
  4. Endorf W., Cancio L.C., Gibran N.S. Toxic epidermal necrolysis clinical guidelines. J. Burn Care Res. 2008; 29: 706.
  5. Johnson R., Jackson R., Bennion S.D. The effect of toxic epidermal necrolysis and erythema multiforme major patients sera on human keratinocyte viability in culture. Clin. Res. 1994;
  6. Самцов А.В., Белоусова И.Э. Буллезные дерматозы: монография. СПб.: Коста, 2012. [Samtsov A.V., Belousova I.E. Bulleznye dermatozy: monographiya. -Petersburg: Kosta, 2012. (In Russ)]
  7. Valeyrie-Allanore L. Fitzpatrick’s Dermatology in General Medicine. 8th Ch. 40. Epidermal Necrolysis (Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis). 2012.
  8. Roujeau J.C., Guillaume J.C., Fabre P. et al. Toxic epidermal necrolysis (Lyell syndrome). Incidence and drug etiology in France (1981–1985). Arch. Dermatol. 1990; 126: 37.
  9. Roujeau J.C., Kelly P., Naldi L. et al. Medication use and the risk of Stevens—Johnson syndrome or toxic epidermal necrolysis. N. Engl. J. Med. 1995; 333: 1600–1607.
  10. Mockenhaupt M., Viboud C., Dunant A. et al. Stevens—Johnson syndrome and toxic epidermal necrolysis: Assessment of medication risks with emphasis on recently marketed The Euro SCAR-study. J. Invest. Dermatol. 2008; 128: 35–44.
  11. Auquier-Dunant A., Mockenhaupt M., Naldi L. et al. Correlation between clinical patterns and causes of erythema multiforme major, Stevens Johnson and toxic epidermal necrolysis. Arch. Dermatol. 2002; 138: 1019–1024.
  12. Rzany B., Correia O., Kelly P. et al. Risk of Stevens-Johnson syndrome and toxic epidermal necrolysis during first weeks of antiepileptic therapy: A case control study. Lancet. 1999; 353: 2190–2194.
  13. Halevy S., Ghislain D., Mockenhaupt M. et al. Allopurinol is the most common cause of Stevens—Johnson syndrome and toxic epidermal necrolysis in Europe and Israel. J. Am. Acad. Dermatol. 2008; 58: 25–32.
  14. Fagot J.P., Mockenhaupt M., Bouwes-Bavinck J.N. et al. Nevirapine and the risk of Stevens—Johnson syndrome or toxic epidermal AIDS. 2001; 15: 1843–1848.
  15. Mockenhaupt M., Messenheimer J., Tennis , Schlingmann J. Risk of Stevens—Johnson and toxic epidermal necrolysis in new users of antiepileptics. Neurology. 2005; 64: 1134–1138.
  16. Sassolas B., Haddad C., Mockenhaupt M. et al. ALDEN, an algorithm for assessment of drug causality in Stevens—Johnson syndrome and toxic epidermal necrolysis: Comparison with case-control analysis. Clin. Pharmacol. Ther. 2010; 88(1): 60–68.
  17. Paul C., Wolkenstein , Adle H. et al. Apoptosis as a mechanism of keratinocyte death in toxic epidermal necrolysis. Br. J. Dermatol. 1996; 134: 710–714.
  18. Abe , Yoshioka N., Murata J., Fujita Y., Shimizu H. Granulysin as a marker for early diagnosis of the Stevens—Johnson syndrome. Ann. Intern. Med. 2009; 151: 514–515.
  19. Shay , Kheirkhah A., Liang L. et al. Amniotic membrane transplantation as a new therapy for the acute ocular manifestations of Stevens—Johnson syndrome and toxic epidermal necrolysis. Surv. Ophthalmol. 2009; 54: 686–696.
  20. Lebargy , Wolkenstein P., Gisselbrecht M. et al. Pulmonary complications in toxic epidermal necrolysis: Prospective clinical study. Intensive Care Med. 1997; 23: 1237–1244.
  21. Bastuji-Garin S., Fouchard N., Bertocchi M. et al. SCORTEN: A severity-of illness score for toxic epidermal necrolysis. J. Invest. Dermatol. 2000; 115: 149–153.
  22. Correia O., Delgado L., Ramos P., Resende C., Torrinha J.A. Cutaneous T-cell recruitment in toxic epidermal necrolysis: Further evidence of CD8+ lymphocyte involvement. Arch. Dermatol. 1993; 129: 466–468.
  23. Шлык И.В., Крылов К.М. Лечение поражений дыхательных путей у пострадавших с комбинированной термической травмой: Учеб. пособие. СПб.: Изд-во НИИ СП им. И.И. Джанелидзе, [Shlyk I.V., Krylov K.M. Lechenie porazhenii dyhatel’nyh putei u postradavshih s kombinirovannoi termicheskoi travmoi. Tutorial. St.-Petersburg: Isd-vo NII SP, 2003. (In Russ)]
  24. Kardaun H., Jonkman M.F. Dexamethasone pulse therapy for Stevens—Johnson syndrome/toxic epidermal necrolysis. Acta Derm.Venereol. 2007; 87: 144. doi: 10.2340/00015555-0214.
  25. Bamichas G., Natse , Christidou F. et al. Plasma exchange in patients with toxic epidermal necrolysis. Ther. Apher. 2002; 6: 225–228.
  26. Wolkenstein , Latarjet J., Roujeau J.C. et al. Randomised comparison of thalidomide versus placebo in toxic epidermal necrolysis. Lancet. 1998; 352: 1586–1589.