scholarly journals Factors Contributing to Long-Term Severe Visual Impairment in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Passara Jongkhajornpong ◽  
Kaevalin Lekhanont ◽  
Sukanya Siriyotha ◽  
Silada Kanokrungsee ◽  
Varintorn Chuckpaiwong
Keyword(s):  
Hiv Infection ◽  
Visual Impairment ◽  
Toxic Epidermal Necrolysis ◽  
Corneal Neovascularization ◽  
Stevens Johnson Syndrome ◽  
Unknown Etiology ◽  
Visual Outcomes ◽  
Johnson Syndrome ◽  
Increased Risk

Purpose. To study the correlation between demographics and clinical variables and long-term severe visual impairment in patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).Methods. A retrospective chart review of SJS/TEN patients between 2004 and 2014 was conducted. Demographics, causative agents, ocular manifestations, and visual outcomes were collected. The data were analyzed using a multivariate logistic regression model.Results. Of the 89 patients including SJS (65, 73.03%), TEN (15, 16.85%), and SJS-TEN overlap (9, 10.11%), 55 were female. The mean age was 41.58 ± 19.17 years. The most common identified agents were medications. Among these groups, antibiotics were the most prevalent (47.19%). Three patients (3.7%) had unknown etiology. Antibiotics and nonpharmaceutical triggers were significantly associated with long-term severe visual impairment (odds ratio 4.32;P=0.015and 7.20;P=0.037, resp.). There was a significant negative relationship between HIV infection and long-term severe visual impairment (P=0.021). Among all chronic ocular complications, only corneal neovascularization significantly correlated with severe visual impairment (P=0.001).Conclusions. SJS/TEN patients caused by nonpharmaceutical triggers or antibiotics have an increased risk of developing long-term severe visual impairment from corneal neovascularization. HIV infection might be a protective factor against long-term poor visual outcomes.

Long-term Progression of Ocular Surface Disease in Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Cornea ◽  
2020 ◽  
Vol 39 (6) ◽  
pp. 745-753
Author(s):  
Yamato Yoshikawa ◽  
Mayumi Ueta ◽  
Hideki Fukuoka ◽  
Tsutomu Inatomi ◽  
Isao Yokota ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

Stevens-Johnson Syndrome and toxic epidermal necrolysis in children: a retrospective study at Srinagarind Hospital, Khon Kaen, Thailand 1992–2012

2017 ◽  
Vol 9 (2) ◽  
pp. 193-196
Author(s):  
Watuhatai Paipool ◽  
Leelawadee Sriboonnark
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Drug Exposure ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Stevens Johnson Syndrome ◽  
Ocular Complications ◽  
Common Mean ◽  
Johnson Syndrome ◽  
Acute Complications

Abstract Background Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening skin conditions with an etiology of drug exposure or infections. Objectives To determine the cause, treatments, complications, and outcomes of SJS/TEN in children admitted to Srinagrind Hospital during 1992–2012. Methods Retrospective chart review. A diagnosis of SJS and TEN was confirmed by pediatric dermatologists. Results A total of 38 patients was recorded. They consisted 31 (82%) SJS patients and 7 (18%) TEN patients. Mean age 6.6 years (range 1 to 14 years). Male to female was 1.1:1. Most cases (30 or 79%) were caused by drug exposure. Three cases (8%) by infection, and 5 cases (13%) were of unknown cause. The antiepileptic drug group was the most common cause. Systemic corticosteroids were used in 33 cases (87%). Intravenous immunoglobulin was used in one TEN patient (3%). There were 18 cases (47%) with acute complications. Ocular complications (7 cases, 39%), septicemia (4 cases, 22%), and secondary skin infections (3 cases, 17%) were the most common. Mean difference in length of hospital stay between those with and without acute complications was 12.3 days (P < 0.01, 95% CI 5.9–18.6). Ocular complications were the only long-term complications at 1-year follow up, and included symblepharon, corneal pannus, and dry eyes. Two patients (5%), both having cases of TEN, died. Conclusions Antiepileptic drugs were the most common causes of SJS/TEN in our study. Good ophthalmologic care of the prevalent acute eye complications in these patients is needed to prevent long-term ophthalmic complications.

scholarly journals Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Guide for Nurses

2020 ◽  
Vol 31 (3) ◽  
pp. 281-295
Author(s):  
Leah M. Hanson ◽  
Amanda P Bettencourt
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Nursing Care ◽  
Psychosocial Support ◽  
Wound Care ◽  
Stevens Johnson Syndrome ◽  
Care Needs ◽  
Current State ◽  
Johnson Syndrome ◽  
State Of The Science

Nurses are central to the care of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Patients with these conditions present with nuanced symptoms and have complex nursing care needs. Although much of the exact pathophysiology of these diseases is not known, all nurses benefit from a fundamental understanding of the genesis of skin manifestations, associated pharmacology, and prognosis. The care of patients hospitalized with Stevens-Johnson syndrome and toxic epidermal necrolysis consists of wound care, infection prevention, comfort management, hydration and nutrition, psychosocial support, and the prevention of long-term complications. This article provides an overview of these diseases, including clinical diagnosis, history and physical assessment, related pharmacology, and nursing care priorities. A description of the current state of the science in clinical management for nurses at all levels is provided, with an emphasis on nursing’s contribution to the best possible patient outcomes.

scholarly journals Toxic epidermal necrolysis (Lyell's syndrome) in a patient with HIV infection.

2021 ◽  
Author(s):  
Darya Popova ◽  
S L Voznesenskiy
Keyword(s):  
Hiv Infection ◽  
Toxic Epidermal Necrolysis ◽  
Clinical Manifestations ◽  
Staphylococcal Infection ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Immunodeficiency Virus ◽  
Lyell’S Syndrome ◽  
Lyell's Syndrome

Lyell's syndrome or toxic epidermal necrolysis (TEN) is more common with human immunodeficiency virus (HIV) infection than in the general population. The article describes a clinical case of Lyell's syndrome in an HIV-infected patient who was first prescribed ART in combination with valganciclovir. The diagnosis was made on the basis of characteristic clinical manifestations and the exclusion of another similar pathology. On the background of the therapy, the rash regressed, the areas of damaged skin became epithelialized, the body temperature returned to normal. A differential diagnosis was made with measles, Stevens-Johnson syndrome, staphylococcal infection. Against the background of the therapy, the patient's condition was positive.

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