Stevens-Johnson Syndrome: Rare cutaneous eruption characterized by extensive KERATINOCYTE apoptosis resulting in skin detachment with mucosal involvement. It is often provoked by the use of drugs (e.g., antibiotics and anticonvulsants) or associated with PNEUMONIA, MYCOPLASMA. It is considered a continuum of Toxic Epidermal Necrolysis.HLA-B15 Antigen: A specific HLA-B surface antigen subtype. Members of this subtype contain alpha chains that are encoded by the HLA-B*15 allele family.Conjunctival DiseasesCarbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of PHENYTOIN; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar.Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms.Chlormezanone: A non-benzodiazepine that is used in the management of anxiety. It has been suggested for use in the treatment of muscle spasm.Drug Eruptions: Adverse cutaneous reactions caused by ingestion, parenteral use, or local application of a drug. These may assume various morphologic patterns and produce various types of lesions.ConjunctivitisAllopurinol: A XANTHINE OXIDASE inhibitor that decreases URIC ACID production. It also acts as an antimetabolite on some simpler organisms.Eye Diseases: Diseases affecting the eye.Anticonvulsants: Drugs used to prevent SEIZURES or reduce their severity.HLA-B Antigens: Class I human histocompatibility (HLA) surface antigens encoded by more than 30 detectable alleles on locus B of the HLA complex, the most polymorphic of all the HLA specificities. Several of these antigens (e.g., HLA-B27, -B7, -B8) are strongly associated with predisposition to rheumatoid and other autoimmune disorders. Like other class I HLA determinants, they are involved in the cellular immune reactivity of cytolytic T lymphocytes.Oral Ulcer: A loss of mucous substance of the mouth showing local excavation of the surface, resulting from the sloughing of inflammatory necrotic tissue. It is the result of a variety of causes, e.g., denture irritation, aphthous stomatitis (STOMATITIS, APHTHOUS); NOMA; necrotizing gingivitis (GINGIVITIS, NECROTIZING ULCERATIVE); TOOTHBRUSHING; and various irritants. (From Jablonski, Dictionary of Dentistry, 1992, p842)Dysuria: Painful URINATION. It is often associated with infections of the lower URINARY TRACT.Corneal Diseases: Diseases of the cornea.Pneumonia, Mycoplasma: Interstitial pneumonia caused by extensive infection of the lungs (LUNG) and BRONCHI, particularly the lower lobes of the lungs, by MYCOPLASMA PNEUMONIAE in humans. In SHEEP, it is caused by MYCOPLASMA OVIPNEUMONIAE. In CATTLE, it may be caused by MYCOPLASMA DISPAR.Amnion: The innermost membranous sac that surrounds and protects the developing embryo which is bathed in the AMNIOTIC FLUID. Amnion cells are secretory EPITHELIAL CELLS and contribute to the amniotic fluid.Syndrome: A characteristic symptom complex.Drug Hypersensitivity: Immunologically mediated adverse reactions to medicinal substances used legally or illegally.Drug-Related Side Effects and Adverse Reactions: Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals.Eye Burns: Injury to any part of the eye by extreme heat, chemical agents, or ultraviolet radiation.Conjunctiva: The mucous membrane that covers the posterior surface of the eyelids and the anterior pericorneal surface of the eyeball.Phenytoin: An anticonvulsant that is used to treat a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs.Immunoglobulins, Intravenous: Immunoglobulin preparations used in intravenous infusion, containing primarily IMMUNOGLOBULIN G. They are used to treat a variety of diseases associated with decreased or abnormal immunoglobulin levels including pediatric AIDS; primary HYPERGAMMAGLOBULINEMIA; SCID; CYTOMEGALOVIRUS infections in transplant recipients, LYMPHOCYTIC LEUKEMIA, CHRONIC; Kawasaki syndrome, infection in neonates, and IDIOPATHIC THROMBOCYTOPENIC PURPURA.

*  Spiractin Stevens-johnson Syndrome Side Effects
View Stevens-johnson Syndrome Spiractin side effect risks. Male, 87 years of age, took Spiractin . ... Is Stevens-johnson Syndrome a common side effect of Spiractin? ... Stevens-johnson Syndrome This Stevens-johnson Syndrome side ... Home → Spiractin → Stevens-johnson Syndrome The following Spiractin Stevens-johnson Syndrome side effect reports were submitted ... Spiractin Stevens-johnson Syndrome Causes and Reviews Your skin is your body's largest organ. It covers and protects your body ...
  http://patientsville.com/spiractin/stevens-johnson-syndrome.htm
*  Erythema multiforme major (Stevens-Johnson syndrome) - Diseases & Conditions
Often, Stevens-Johnson syndrome begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and ... Stevens-Johnson syndrome is a rare, serious disorder of your skin and mucous membranes. It's usually a reaction to a medication ... Definition of Erythema multiforme major (Stevens-Johnson syndrome). Stevens-Johnson syndrome is a rare, serious disorder of ... A family history of Stevens-Johnson syndrome. If an immediate family member has had Stevens-Johnson syndrome or a related ...
  http://pharmacypedia.org/diseases-and-conditions/erythema-multiforme-major-stevens-johnson-syndrome/
*  Stevens Johnson Syndrome | Med-Health.net
Learn the symptoms of Stevens Johnson syndrome to spot it in time and what treatments to expect during the hospitalization. ... Stevens Johnson syndrome is a rare life-threatening skin condition. ... Causes of Stevens Johnson Syndrome (SJS). Stevens Johnson syndrome is unpredictable and its exact cause may be difficult to ... Treatments of Stevens Johnson Syndrome (SJS). Management of Stevens Johnson syndrome is usually done in intensive care units ( ...
  http://www.med-health.net/Stevens-Johnson-Syndrome.html
*  Granulysin as a Marker for Early Diagnosis of the Stevens-Johnson Syndrome | Annals of Internal Medicine | American College of...
Background: The Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening adverse drug reactions ... Granulysin as a Marker for Early Diagnosis of the Stevens-Johnson Syndrome Riichiro Abe, MD, PhD; Naoya Yoshioka, MS; Junko ... Granulysin as a Marker for Early Diagnosis of the Stevens-Johnson Syndrome. Ann Intern Med. 2009;151:514-515. doi: 10.7326/0003 ...
  http://annals.org/aim/article-abstract/744992/granulysin-marker-early-diagnosis-stevens-johnson-syndrome
*  Phase III Clinical Trial of NPB-01 in Patients With Stevens-Johnson Syndrome/ Toxic Epidermal Necrolysis Unresponsive to...
IVIG in Stevens-Johnson syndrome. Toxic Epidermal Necrolysis. Patients with Stevens-Johnson syndrome. Toxic Epidermal ... Syndrome. Stevens-Johnson Syndrome. Disease. Pathologic Processes. Stomatitis. Mouth Diseases. Stomatognathic Diseases. Drug ... Patients diagnosed with Stevens-Johnson syndrome and Toxic Epidermal Necrolysis were confirmed based on the investigators ... Genetics Home Reference related topics: Stevens-Johnson syndrome/toxic epidermal necrolysis Drug Information available for: ...
  https://clinicaltrials.gov/ct2/show/NCT01696500
*  Tony's story: Stevens Johnson Syndrome Literature
... stevens johnson syndrome literature by making the stevens johnson syndrome literature that holds the stevens johnson syndrome ... Aiming to protect the stevens johnson syndrome literature. Unfortunately, surgical procedures that address the stevens johnson ... These individuals do not have much opportunity to interact with the stevens johnson syndrome literature of Down syndrome, ... All humans inherit 23 chromosomes from the stevens johnson syndrome literature from Down syndrome attain same hormonal changes ...
  http://wiehannecontest.blogspot.com/2013/09/stevens-johnson-syndrome-literature.html
*  How to Survive StevensJohnson Syndrome: 10 Steps
Johnson Syndrome. Stevens-Johnson (SJ) syndrome is a rare but serious and potentially life-threatening disorder of the skin and ... wikiHow to Survive StevensJohnson Syndrome. Stevens-Johnson (SJ) syndrome is a rare but serious and potentially life- ... A family history of Stevens-Johnson syndrome. If an immediate family member has had Stevens-Johnson syndrome or a related ... Factors that increase your risk of developing Stevens-Johnson syndrome include: *Viral infections. Your risk of Stevens-Johnson ...
  https://www.wikihow.com/Survive-Stevens%E2%80%90Johnson-Syndrome
*  Stevens Johnson Syndrome Can Be Caused by Medical Malpractice or Improper Labeling
Stevens Johnson Syndrome is a serious, sometimes life-threatening disease of the skin and mucous membranes that can result from ... Stevens Johnson Syndrome Can Be Caused by Medical Malpractice or Drug Makers' Failure to Warn and Improper Labeling. December ... Although not well known to most people, Stevens Johnson Syndrome (SJS) is a serious, sometimes life-threatening disease of the ...
  https://www.sommerspc.com/blog/2013/12/stevens-johnson-syndrome-can-be-caused-by-medical-malpractice-or-drug-makers-failure-to-warn-and-improper-labeling/
*  Stevens johnson syndrome treatment steroids | Stevens-Johnson syndrome - Wikipedia
Stevens-Johnson syndrome: A serious systemic (body-wide) allergic reaction with a characteristic rash involving the skin and ... Stevens Johnson Syndrome is a severe expression of a simple rash known as erythema multiforme. Stevens Johnson Syndrome is also ... Most cases of Stevens Johnson Syndrome appear in children and young adults under age 30. Females with Stevens Johnson Syndrome ... Stevens johnson syndrome treatment steroids. Stevens-Johnson syndrome: A serious systemic (body-wide) allergic reaction with a ...
  http://luy.steroids-australia.net/stevens-johnson-syndrome-treatment-steroids.html
*  Stevens Johnson Syndrome
Read stories about BostonSight PROSE patients with Stevens Johnson sundrome (SJS) and their experiences with BostonSight PROSE ... When Stevens Johnson syndrome hit 22 year-old Jeriann Peabody last October, it hit her hard. By the time she left the hospital ... But as anyone who develops Stevens Johnson syndrome (SJS) knows, medication toxicity can trigger a serious, overwhelming ... the most severe form of Stevens Johnson syndrome (SJS). Her first symptom appeared on a Monday; she awoke with a large, painful ...
  http://www.bostonsight.org/PROSE/For-Patients/Patient-Stories/Stevens-Johnson-Syndrome
*  Stevens-Johnson Syndrome Foundation | National Eye Institute
Provides information and support for people with Stevens Johnson syndrome and toxic epidermal necrolysis, skin and eye problems ... Stevens-Johnson Syndrome Foundation. Provides information and support for people with Stevens Johnson syndrome and toxic ...
  https://www.nei.nih.gov/node/2083
*  Alternative treatments for stevens johnson syndrome - Doctors answer your questions
Kerr on alternative treatments for stevens johnson syndrome: The only known treatment for sjs is to avoid the offending agent ( ... for topic: Alternative Treatments For Stevens Johnson Syndrome ... Signs of stevens johnson syndrome * What is stevens johnson ... Stevens-Johnson: Stevens-johnson syndrome is a rare, serious disorder in which your skin and mucous membranes react severely to ... Not good : There is no history here but with stevens Johnson this is not good. This can be a cause of stevens Johnson. At a ...
  https://www.healthtap.com/topics/alternative-treatments-for-stevens-johnson-syndrome
*  Methazolamide Side Effects May Result In Stevens Johnson Syndrome Lawsuits - Parker Waichman LLP
Stevens Johnson Syndrome can cause rash, skin peeling, and sores on the mucous membranes. Stevens Johnson Syndrome is an immune ... Methazolamide Side Effects May Result In Stevens Johnson Syndrome Lawsuits. Methazolamide Side Effects May Result In Stevens ... Many drugs that cause the onset of Stevens Johnson Syndrome did not have warnings placed on their labels until recently. ... There have been instances of people taking Methazolamide developing Stevens Johnson Syndrome (SJS), a rare skin disease. ...
  https://www.yourlawyer.com/defective-drugs/methazolamide/methazolamide/
*  Steven Johnson Syndrome | allnurses
I was just wondering what everyones experience was with this syndrome. Although I no longer work in burns in the time I was ... Steven Johnsons and TENS tend to be partial thickness wounds and really dont require all those extensive and disruptive ... I was just wondering what everyones experience was with this syndrome. Although I no longer work in burns in the time I was ...
  http://allnurses.com/burn-nursing/steven-johnson-syndrome-50277.html
*  Stevens Johnson Syndrome - NYEE
Stevens-Johnson Syndrome. What is Stevens-Johnson syndrome?. Stevens-Johnson syndrome is a rare, serious disorder of the skin ... Stevens-Johnson syndrome has a 5%-15% mortality rate. Ocular involvement, which occurs in as many as half of patients, varies ... Stevens-Johnson syndrome is a medical emergency that usually requires hospitalization. The first and most important step in ... All Stevens-Johnson syndrome patients need emergent consultation with an ophthalmologist at the time of diagnosis. ...
  http://www.nyee.edu/patient-care/ophthalmology/cornea-refractive-surgery/about/stevens-johnson-syndrome
*  Association between Stevens-Johnson syndrome and benoxaprofen. | The BMJ
Association between Stevens-Johnson syndrome and benoxaprofen. Br Med J (Clin Res Ed) 1981; 283 :144 ... Association between Stevens-Johnson syndrome and benoxaprofen.. Br Med J (Clin Res Ed) 1981; 283 doi: https://doi.org/10.1136/ ...
  http://www.bmj.com/content/283/6284/144.3
*  Stevens-Johnson Syndrome Articles - The People's Pharmacy
Q. I read with interest your column regarding Stevens-Johnson syndrome (SJS). My brother was diagnosed with gout and given ...
  https://www.peoplespharmacy.com/health-concerns/stevens-johnson-syndrome/
*  Search of: 'Stevens-Johnson syndrome' - List Results - ClinicalTrials.gov
Efficacy of 0.05% Cyclosporin Eye Drop in Stevens Johnson Syndrome Patient With Chronic Dry Eye. *Stevens-Johnson Syndrome ... Cyclosporine and Etanercept in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. *Stevens-Johnson Syndrome ... Corneal Epitheliotropic Factors in Autologous Serum Eye Drops in Nonautoimmune and Stevens-Johnson Syndrome With Dry Eye. * ... Salivary Gland Transplantation in the Treatment of Dry Eye in Patients With Stevens-Johnson Syndrome.. *Symblepharon ...
  https://clinicaltrials.gov/ct2/results?cond=%22Stevens-Johnson+syndrome%22
*  PatientsLikeMe | Stevens Johnson syndrome symptoms, treatments & patient forums | PatientsLikeMe
63 patients with Stevens Johnson syndrome experience fatigue, depressed mood, pain, anxious mood, and insomnia and use ... Find the most comprehensive real-world symptom and treatment data on Stevens Johnson syndrome at PatientsLikeMe. ... and Diazepam to treat their Stevens Johnson syndrome and its symptoms. ... What is Stevens Johnson syndrome?. Stevens-Johnson syndrome (SJS) is a life-threatening condition affecting the skin in which ...
  https://www.patientslikeme.com/conditions/1300-stevens-johnson-syndrome
*  Stevens Johnson syndrome - RightDiagnosis.com
Diagnostic checklist, medical tests, doctor questions, and related signs or symptoms for Stevens Johnson syndrome. ... List of 37 disease causes of Stevens Johnson syndrome, patient stories, diagnostic guides, 36 drug side effect causes, 25 drug ... Basic Summary for Stevens-Johnson Syndrome *Treatments for Stevens Johnson syndrome. *Drug Causes of Stevens-Johnson Syndrome * ... Stevens Johnson syndrome and Vomiting (14 causes) *Stevens Johnson syndrome and Headache (13 causes) *Stevens Johnson syndrome ...
  http://www.rightdiagnosis.com/sym/stevens_johnson_syndrome.htm
*  Stevens Johnson Syndrome patient stories - BostonSight PROSE
Read stories about BostonSight PROSE patients with Stevens Johnson sundrome (SJS) and their experiences with BostonSight PROSE ... TENS, a severe form of Stevens Johnson syndrome (SJS), also attacks the mucous membranes, including the ocular surface of the ... The doctors had pretty much worked out that this was classic TENS (toxic epidermal necrolysis syndrome) and suggested we either ... Out of nowhere, Kelli, 36, contracted toxic epidermal necrolysis syndrome (tens), a rare disease thought to result from an ...
  http://www.bostonsight.org/PROSE/For-Patients/Patient-Stories/Stevens-Johnson-Syndrome/item/2871/Turning-Things-Around
*  Mycoplasma pneumonia, Stevens-Johnson syndrome, and chronic obliterative bronchitis. | Thorax
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center's RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.. ...
  http://thorax.bmj.com/content/38/11/867.info
*  ASMscience | Lyme Borreliosis
160. Klempner, M. S.,, L. T. Hu,, J. Evans,, C. H. Schmid,, G. M. Johnson,, R. P. Trevino,, D. Norton,, L. Levy,, D. Wall,, J. ... 143. Jacobs, J. C.,, M. Stevens,, and P. H. Duray. 1986. Lyme disease simulating septic arthritis. JAMA 256:1138-1139.. ... Bannwarth's syndrome). Ann. Neurol. 20:337-345.. ... 147. Johnson, R. C.,, G. P. Schmid,, F. W. Hyde,, A. G. ... 42. Brown, E. L.,, R. M. Wooten,, B. J. Johnson,, R. V. Iozzo,, A. Smith,, M. C. Dolan,, B. P. Guo,, J. J. Weis,, and M. Hook. ...
  http://www.asmscience.org/content/book/10.1128/9781555816490.chap11
*  ICT Enhanced Learning and Teaching: April 2016
Ken Stevens' (1) * 'Knowledge Creation' (1) * 'Kwok Wing Lai' (1) * 'Lane Clark' (1) ... marcia johnson' (1) * 'mature students' (1) * 'meeting in Wellington' (1) * 'metacognitive skills' (1) ... Asperger syndrome (1) * Aspergers (1) * Audio description (1) * AudioBoo (1) * Auditory learning (1) ...
  http://ictelt.blogspot.fr/2016/04/
*  EndrTimes: GAWKER EXPOSED HILLARY'S SECRET BEFORE ITS DESTRUCTION! "AMERICA'S WIKIL...
Stevens-Arroyo (1) Stewarship (6) Stiglitz (3) stimulus (30) sting (3) stock markets (36) Stockholm (2) Stockholm Syndrome (1) ... Johnson (1) G. Kah (4) G. Kicanas (1) G. Liddy (1) G. Locke (1) G. McGill (2) G. Napolitano (1) G. Osborne (3) G. Pell (2) G. ... syndrome (1) Synod (6) Syria (67) Szymanski (4) t (2) T. Abbot (2) T. Abbott (1) T. Aka (1) T. Alamo (5) T. Ashbrook (1) T. ... Stevens (1) J. Petras (1) J. Pilger (1) J. Piper (1) J. Randall Price (1) J. Retinger (1) J. Robbins (1) J. Robbinson (1) J. ...
  http://endrtimes.blogspot.com/2016/12/gawker-exposed-hillarys-secret-before.html

Stevens–Johnson syndromeConjunctivochalasisCarbamazepineErythema multiforme majorDrug eruptionLigneous conjunctivitis: Ligneous conjunctivitis is a rare form of chronic conjunctivitis characterized by recurrent, fibrin-rich pseudomembranous lesions of wood-like consistency that develop mainly on the underside of the eyelid (tarsal conjunctiva). It is generally a systemic disease which may involve the periodontal tissue, the upper and lower respiratory tract, kidneys, middle ear, and female genitalia.AllopurinolNeuro-ophthalmology: Neuro-ophthalmology is an academically-oriented subspecialty that merges the fields of neurology and ophthalmology, often dealing with complex systemic diseases that have manifestations in the visual system. Neuro-ophthalmologists initially complete a residency in either neurology or ophthalmology, then do a fellowship in the complementary field.Protective index: The protective index is a comparison of the amount of a therapeutic agent that causes the therapeutic effect to the amount that causes toxicity. Quantitatively, it is the ratio given by the toxic dose divided by the therapeutic dose.DysuriaBullous keratopathyMycoplasma pneumoniaSurface reconstruction: Surface reconstruction refers to the process by which atoms at the surface of a crystal assume a different structure than that of the bulk. Surface reconstructions are important in that they help in the understanding of surface chemistry for various materials, especially in the case where another material is adsorbed onto the surface.Malformative syndrome: A malformative syndrome (or malformation syndrome) is a recognizable pattern of congenital anomalies that are known or thought to be causally related (VIIth International Congress on Human Genetics).Drug allergyIdiosyncratic drug reactionChemical eye injury: Chemical eye injury or chemical burns to the eye are due to either an acidic or alkali substance getting in the eye. Alkalis are typically worse than acidic burns.Conjunctiva: The conjunctiva lines the inside of the eyelids and covers the sclera (white part of the eye). It is composed of non-keratinized, stratified columnar epithelium with goblet cells, and also stratified columnar epithelium.PhenytoinLennox–Gastaut syndrome

(1/219) Epithelial hyperproliferation and transglutaminase 1 gene expression in Stevens-Johnson syndrome conjunctiva.

In Stevens-Johnson syndrome, pathological keratinization of the ordinarily nonkeratinized corneal and conjunctival mucosal epithelia results in severe visual loss. We examined conjunctiva covering cornea in five eyes in the chronic cicatricial phase of Stevens-Johnson syndrome. Normal conjunctiva from five age-matched individuals was studied also. The number of epithelial cells in Stevens-Johnson syndrome conjunctiva that were immunoreactive with a monoclonal antibody, Ki-67, to a nuclear antigen found only in proliferating cells was greater than normal (93.8+/-19.8 cells above 100 basal cells versus 12.8+/-0.5 cells above 100 basal cells; P = 0.009). In addition, although clinical inflammation was mild, massive lymphocytic infiltration was seen in the substantia propria of conjunctiva covering cornea. In situ hybridization documented transglutaminase 1 (keratinocyte transglutaminase) mRNA in suprabasal cells of the abnormally thickened conjunctival epithelium in all Stevens-Johnson syndrome patients. In contrast, no message was detected in normal conjunctival or corneal epithelia. Transglutaminase 1 is expressed during the terminal differentiation of keratinocytes where it helps synthesize cornified cell envelopes. We speculate that in Stevens-Johnson syndrome, epithelial hyperproliferation, and transglutaminase 1 gene expression lead to the pathological keratinization of ocular surface mucosal epithelia.  (+info)

(2/219) Blister fluid T lymphocytes during toxic epidermal necrolysis are functional cytotoxic cells which express human natural killer (NK) inhibitory receptors.

Toxic epidermal necrolysis (TEN) is a rare life-threatening adverse drug reaction characterized by a massive destruction of the epidermis. Immunohistological studies of skin biopsies of TEN showed infiltrates of predominantly CD8+ T lymphocytes even though other authors reported a prominent involvement of cells of the monocyte-macrophage lineage. The aim of this study was to characterize phenotypically and functionally the cells present in the cutaneous blister fluid of four patients with TEN. We first determined that lymphocytes were predominant in blister fluid obtained early, while monocytes/macrophages later became the most important population. We then showed that this lymphocyte population, mainly CD3+CD8+, corresponded to a peculiar cell subset as they expressed cutaneous leucocyte antigen, killer inhibitory receptors KIR/KAR and failed to express CD28 molecule. Functionally, we determined that blister T lymphocytes had a cytotoxic T lymphocyte (CTL)- and NK-like cytotoxicity. The role of this cytotoxic lymphocyte population present at the site of lesions during TEN remains to be understood.  (+info)

(3/219) Nitric oxide synthase in toxic epidermal necrolysis and Stevens-Johnson syndrome.

Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe cutaneous drug reactions of unknown mechanism. Nitric oxide can cause apoptosis and necrosis. The inducible form of nitric oxide synthase generates large amounts of nitric oxide and has been described in human skin. We propose that a large burst of nitric oxide in toxic epidermal necrolysis and Stevens-Johnson syndrome may cause the epidermal apoptosis and necrosis. Skin biopsies were taken from seven patients with actively progressing Stevens-Johnson syndrome or toxic epidermal necrolysis. Expression of inducible nitric oxide synthase was examined by reverse transcription-polymerase chain reaction and by immunoperoxidase staining for inducible nitric oxide synthase protein. Messenger RNA for inducible nitric oxide synthase was detected by reverse transcription-polymerase chain reaction and confirmed by the sequencing of polymerase chain reaction products. Strong staining for inducible nitric oxide synthase was observed in inflammatory cells in the lower epidermis and upper dermis. Diffuse, weaker staining was observed in keratinocytes. Expression of inducible nitric oxide synthase is consistent with the hypothesis that nitric oxide mediates the epidermal necrosis in toxic epidermal necrolysis and provides a potential target for therapeutic intervention.  (+info)

(4/219) SCORTEN: a severity-of-illness score for toxic epidermal necrolysis.

The mortality of toxic epidermal necrolysis is about 30%. Our purpose was to develop and validate a specific severity-of-illness score for cases of toxic epidermal necrolysis admitted to a specialized unit and to compare it with the Simplified Acute Physiology Score and a burn scoring system. A sample of 165 patients was used to develop the toxic epidermal necrolysis-specific severity-of-illness score and evaluate the other scores, a sample of 75 for validation. Model development used logistic regression equations that were translated into probability of hospital mortality; validation used measures of calibration and discrimination. We identified seven independent risk factors for death and constituted the toxic epidermal necrolysis-specific severity-of-illness score: age above 40 y, malignancy, tachycardia above 120 per min, initial percentage of epidermal detachment above 10%, serum urea above 10 mmol per liter, serum glucose above 14 mmol per liter, and bicarbonate below 20 mmol per liter. For each toxic epidermal necrolysis-specific severity-of-illness score point the odds ratio was 3.45 (confidence interval 2.26-5.25). Probability of death was: P(death) = elogit/1 + elogit with logit = -4.448 + 1.237 (toxic epidermal nec-rolysis-specific severity-of-illness score). Calibration demonstrated excellent agreement between expected (19. 6%) and actual (20%) mortality; discrimination was also excellent with a receiver operating characteristic area of 82%. The Simplified Acute Physiology Score and the burn score were also associated with mortality. The discriminatory powers were poorer (receiver operating characteristic area: 72 and 75%) and calibration of the Simplified Acute Physiology Score indicated a poor agreement between expected (9.1%) and actual (26.7%) mortality. This study demonstrates that the risk of death of toxic epidermal necrolysis patients can be accurately predicted by the toxic epidermal necrolysis-specific severity-of-illness score. The Simplified Acute Physiology Score and burn score appear to be less adequate.  (+info)

(5/219) Diagnosis, classification, and management of erythema multiforme and Stevens-Johnson syndrome.

BACKGROUND: In adults, erythema multiforme (EM) is thought to be mainly related to herpes infection and Stevens-Johnson syndrome (SJS) to drug reactions. AIMS: To investigate this hypothesis in children, and to review our experience in the management of these patients. METHODS: A retrospective analysis of 77 paediatric cases of EM or SJS admitted to the Children's Hospital in Bordeaux between 1974 and 1998. RESULTS: Thirty five cases, inadequately documented or misdiagnosed mostly as urticarias or non-EM drug reactions were excluded. Among the remaining 42 patients (14 girls and 28 boys), 22 had EM (11 EM minor and 11 EM major), 17 had SJS, and three had isolated mucous membrane involvement and were classified separately. Childhood EM was mostly related to herpes infection and SJS to infectious agents, especially Mycoplasma pneumoniae. Only two cases were firmly attributed to drugs (antibiotics). No patient died. EM and SJS sequelae were minor and steroids were of no overall benefit. CONCLUSION: In paediatric practice EM is frequently misdiagnosed. The proposal that SJS is drug related in adults does not apply to children, and in our recruitment EM and SJS are mostly triggered by infectious agents. The course of both diseases, even though dramatic at onset, leads to low morbidity and mortality when appropriate symptomatic treatment is given.  (+info)

(6/219) Conjunctival inflammation in the chronic phase of Stevens-Johnson syndrome.

AIMS: To understand the immunopathogenesis of the corneal conjunctivalisation in Stevens-Johnson syndrome. METHODS: Conjunctivalised corneas from five patients with Stevens-Johnson syndrome were studied immunohistochemically for several cell surface antigens and two cytokines. Chemical injury specimens were also studied. RESULTS: In all cases, immunohistochemistry revealed LFA-1, CD4, CD8, and CD68 on subepithelial infiltrating cells. Also, HLA-DR and ICAM-1 were found on the surfaces of epithelial cells, subepithelial infiltrating cells, subepithelial fibroblasts, and endothelial cells in blood vessels. IFN-gamma was found in basal epithelial cells; subepithelial cells and subepithelial extracellular matrix CD19 and IL4 were not detected. CONCLUSIONS: The infiltrating cell population in the Stevens-Johnson syndrome samples includes macrophages, CD4 positive T cells, and CD8 positive T cells. The cytokine expression pattern suggests CD4 positive T cells are Th1 cells. The infiltrating cell population is similar in Stevens-Johnson syndrome and chemical injury conjunctivalised corneas.  (+info)

(7/219) Toxic epidermal necrolysis in a monkey (Macaca fascicularis).

An adult male Macaca fascicularis monkey developed toxic epidermal necrolysis after ingestion of methylmercury. The clinical picture was characterized by the development of large cutaneous bullae with subsequent full-thickness epidermal exfoliation. Areas of sparse pelage were most affected, with the most severe exfoliation occurring on the palms, soles, face and ears. Erosions also developed within the oral mucosa and conjunctivae.  (+info)

(8/219) Patients with acute skin loss: are they best managed on a burns unit?

Patients who are critically ill and have large areas of skin loss or breakdown present a difficult management problem. They require the combination of intensive therapy facilities to support failing organs and specialized skin care, sometimes including extensive debridement and reconstruction. The expertise required for both aspects of treatment are found uniquely on a burns unit. We present five patients with large areas of cutaneous loss or damage secondary to a variety of non-burn aetiologies who were managed on a burns unit. We suggest that a burns unit may be the most appropriate place for such patients to be treated during both the acute phase of their illness and the later stages of surgical reconstruction and physical rehabilitation.  (+info)



  • exact
  • The exact relationship between karyotype-phenotype characteristics that result in Turner syndrome suffer from atrioventricular septal defect. (blogspot.com)
  • options
  • The more you talk openly and honestly with your Down syndrome now have many options and opportunities available to them, and it occurs when one of these drugs one week before undergoing dexamethasone suppression test. (blogspot.com)