Emergency Medicine News & Articles

1 HLA-B*5801: utility and cost-effectiveness in the Asia-Pacific Region International Journal of Rheumatic Diseases, April 29, 2013
Yeo SI et al. - A recent multi-national case-control study has reported allopurinol as the most common drug associated with stevens-johnson syndrome and toxic epidermal necrolysis. Several studies have established a strong association between the human leukocyte antigen (HLA)-B*5801 gene and development of stevens-johnson syndrome and toxic epidermal necrolysis. The allele frequency of HLA-B*5801 is highest in the South East Asian population.Since ...

2 A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population Indian Journal of Dermatology, Venereology and Leprology , May 10, 2013
Patel TK et al. - In a study to do a systematic review of the published evidence of the drug-induced stevens-johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in an Indian population, it was found that carbamazepine, phenytoin, fluoroquinolones, and paracetamol were the major causative drugs. TEN is showing higher mortality, morbidity, and economic burden than SJS. Methods Publications from 1995 to 2011 describing SJS and TEN in Indian population were ...

3 Placement of ProKera in the Management of Ocular Manifestations of Acute Stevens-Johnson Syndrome in an Outpatient Eye & Contact Lens: Science and Clinical Practice, May 6, 2013
Kolomeyer AM et al. - This study aims to report the clinical use of ProKera (Bio-Tissue, Inc., Miami, FL) under topical anesthesia in an outpatient for the management of ocular manifestations of acute stevens-johnson syndrome (SJS). ProKera placement performed under topical anesthesia may be appropriate for the treatment of ocular surface manifestations of acute SJS particularly in those patients followed in an outpatient setting with milder forms of disease and/or with ...

4 Intravenous immune globulin therapy for Stevens-Johnson syndrome/toxic epidermal necrolysis complicated by hemolysis leading to pigment nephropathy and hemodialysis Journal of the American Academy of Dermatology, May 14, 2013
Ririe MR et al. - The authors aims to evaluated the underlying cause of anemia and renal failure in 2 consecutive patients being treated with IVIG for stevens-johnson syndrome/toxic epidermal necrolysis. They propose that IVIG-associated hemolysis is an adverse reaction that may not be as rare as once thought, presenting as a mild decrease in hemoglobin and hematocrit. Antibodies to blood type A and B are given as part of pooled immune globulin and are considered to be the ...

5 27 years of a single burn centre experience with Stevens-Johnson syndrome and toxic epidermal necrolysis: Analysis of mortality risk for causative agents Burns, May 23, 2013
Weinand C et al. - stevens–johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life threatening unwanted side effects, mainly from medication. Pathophysiology is still being debated. The disease usually requires treatment in burn units. When SJS/TEN is caused by antibiotics suspicion of developing a fatal sepsis should be high. Patients’ medical condition when initiating therapy with a potential causing agent also might influence medical outcome.

6 Phenobarbital-induced severe cutaneous adverse drug reactions are associated with CYP2C19*2 in Thai children Pediatric Allergy and Immunology, April 8, 2013
Manuyakorn W et al. - Aromatic anticonvulsant–induced severe cutaneous adverse drug reactions (SCARs), including stevens–johnson syndrome (SJS), toxic epidermal necrosis (TEN), and drug rash with eosinophilia and systemic symptoms (DRESS), are fatal immune-mediated adverse drug reactions. CYP2C19, a cytochrome P450 isoform, plays a role in metabolic rate of aromatic anticonvulsant. HLA-B*1502 has also been demonstrated to be associated with carbamazepine-induced ...

7 Acute blistering diseases on the burn ward: Beyond Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Burns, April 18, 2013
Richer V et al. - The aim of the study was to identify the final diagnosis in patients transferred for widespread blistering disease and to identify clinical features at admission predicting final diagnosis. Extensive skin detachment surface and morphological features (tense bullae, pustules) were statistically significant clinical clues to final diagnosis. Patients transferred for widespread blistering disease should be thoroughly evaluated in order to exclude other causes of acute ...

8 In vitro drug causality assessment in Stevens-Johnson syndrome - alternatives for lymphocyte transformation test Clinical & Experimental Allergy, May 17, 2013
Porebski G et al. - As provocation tests are considered as too dangerous, there is an urgent need to identify the relevant drug in SJS/TEN and to improve sensitivity of tests able to identify the causative drug. Granulysin expression in CD3+CD4+, Granzyme B-ELISpot and IFNγ production) considered together provided a sensitivity of 80% (CI:52-96%) and specificity of 95% (80-99%). Thus, this study demonstrated that combining different assays may be a feasible ...

9 HLA-B alleles associated with severe cutaneous reactions to antiepileptic drugs in Han Chinese Epilepsia, May 21, 2013
Cheung YK et al. - The authors examined whether other HLA-B alleles are also involved and whether the association extends to other antiepileptic drugs (AEDs). stevens-johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) induced by carbamazepine and phenytoin is strongly and moderately associated with HLA-B*15:02 in Han Chinese, respectively. Possible protective associations with HLA-B*40:01 and HLA-B*58:01 warrant further investigation.

10 Epidemiology of ophthalmologic disease associated with erythema multiforme, stevens-johnson syndrome, and toxic epidermal necrolysis in hospitalized children in the United States Pediatric Dermatology, May 24, 2013
Moreau JF et al. - The objective of the current study was to characterize the epidemiology and resource use of U.S. children hospitalized with ophthalmologic disease secondary to erythema multiforme (EM), stevens-johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). They studied children ages 5 to 19 years hospitalized in 2005 in 11 states, encompassing 38% of the U.S. pediatric population. In children with EM, SJS, or TEN, ophthalmologic disease was most common in those ...