PMID- 24260726
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20131122
LR  - 20211021
IS  - 2233-8276 (Print)
IS  - 2233-8268 (Electronic)
IS  - 2233-8276 (Linking)
VI  - 3
IP  - 4
DP  - 2013 Oct
TI  - Stevens-Johnson syndrome / toxic epidermal necrolysis: an Asia-Pacific 
      perspective.
PG  - 215-23
LID - 10.5415/apallergy.2013.3.4.215 [doi]
AB  - Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe 
      cutaneous adverse reactions (SCAR) to drugs which are associated with significant 
      morbidity and mortality. High risk drugs in Asia are similar to those reported 
      worldwide. Human leukocyte antigen (HLA)-related risk alleles for carbamazepine 
      and allopurinol SCAR are unique to Asians. Although prognostic scoring systems 
      like the SCORTEN have been used for more than a decade, pitfalls and caveats need 
      to be recognized, in particular in patients with multiple medical co-morbidities 
      and systemic features in SJS/TEN. In centres without a tertiary Burns Centre, 
      SJS/TEN patients can still be managed successfully in general and dermatology 
      wards with well-executed supportive/nursing care. Controversy remains regarding 
      the effectiveness of immunomodulation in reducing SJS/TEN morbidity, mortality 
      and hastening re-epithelialization. Despite paucity of robust evidence, 
      intravenous immunoglobulins and ciclosporin remain the most commonly used 
      modalities worldwide. Acute and long-term ocular effects are an important source 
      of morbidity for which emerging ophthalmic therapies appear promising. Quality of 
      life issues have now become an important outcome in patients with SJS/TEN as they 
      often impact survivors' future attitudes towards pharmacotherapy. Even though 
      pharmacogenetic testing for high-risk drugs appears to be the panacea for 
      preventing carbamazepine- and allopurinol-induced SJS/TEN in ethnic Asians, many 
      issues remain before health regulators in our region can conclusively determine 
      whether testing should be made mandatory or highly recommended as standard of 
      care.
FAU - Thong, Bernard Yu-Hor
AU  - Thong BY
AD  - Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, 
      Singapore 308433, Singapore.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20131031
PL  - Netherlands
TA  - Asia Pac Allergy
JT  - Asia Pacific allergy
JID - 101561954
PMC - PMC3826606
OTO - NOTNLM
OT  - HLA antigens
OT  - Immunomodulatory therapy
OT  - Pharmacogenetics
OT  - Quality of life
EDAT- 2013/11/22 06:00
MHDA- 2013/11/22 06:01
PMCR- 2013/10/01
CRDT- 2013/11/22 06:00
PHST- 2013/09/16 00:00 [received]
PHST- 2013/09/22 00:00 [accepted]
PHST- 2013/11/22 06:00 [entrez]
PHST- 2013/11/22 06:00 [pubmed]
PHST- 2013/11/22 06:01 [medline]
PHST- 2013/10/01 00:00 [pmc-release]
AID - 10.5415/apallergy.2013.3.4.215 [doi]
PST - ppublish
SO  - Asia Pac Allergy. 2013 Oct;3(4):215-23. doi: 10.5415/apallergy.2013.3.4.215. Epub 
      2013 Oct 31.