PMID- 27400826
OWN - NLM
STAT- MEDLINE
DCOM- 20170123
LR  - 20170123
IS  - 1440-1592 (Electronic)
IS  - 1323-8930 (Linking)
VI  - 66
IP  - 1
DP  - 2017 Jan
TI  - A review of toxic epidermal necrolysis management in Japan.
PG  - 36-41
LID - S1323-8930(16)30066-1 [pii]
LID - 10.1016/j.alit.2016.06.001 [doi]
AB  - Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction characterized 
      by necrosis of the epidermis. Its incidence is approximately 1 per million a year 
      and average mortality rate is high at 25-50%. TEN has a flu-like prodrome, 
      followed by atypical, targetoid erythematous or purpuric macules on the skin. 
      These macules coalesce to form flaccid blisters that slough off as areas of 
      epidermal necrosis. Drugs such as allopurinol, sulfonamides, and carbamazepine 
      are the most common causes. The human leukocyte antigen (HLA)-B*15:02 in Asians 
      being administered carbamazepine and the HLA-B*58:01 antigen in patients of all 
      ethnicities being administered allopurinol are known to be high-risk factors. 
      Rapid diagnosis, discontinuation of the causative drug, and supportive treatment 
      are essential for better prognosis and improvement of sequelae. Till now, 
      systemic corticosteroids and intravenous immunoglobulins have been used as the 
      most common active interventions; however, no gold standard has been established. 
      In Japan, physicians follow a unique diagnostic criteria and treatment guideline 
      to improve the diagnosis rate and streamline treatments. This may be a 
      contributing factor for the lower mortality rate (14.3%). The efficacy of 
      systemic corticosteroids, immunoglobulins, and plasmapheresis may have been 
      beneficial as well. In Japan, TEN is defined as an epidermal detachment of over 
      10% of the body surface area (BSA), while the globally accepted definition 
      established by Bastuji-Garin describes it as an epidermal detachment of over 30% 
      of the BSA. In Japanese individuals, HLA-A*02:06, HLA-A*02:07, HLA-A*31:01 and 
      HLA-B*51:01 may be linked to higher risks of TEN.
CI  - Copyright (c) 2016 Japanese Society of Allergology. Production and hosting by 
      Elsevier B.V. All rights reserved.
FAU - Kinoshita, Yuri
AU  - Kinoshita Y
AD  - Department of Dermatology, Nippon Medical School, Tokyo, Japan. Electronic 
      address: yuri-kino@nms.ac.jp.
FAU - Saeki, Hidehisa
AU  - Saeki H
AD  - Department of Dermatology, Nippon Medical School, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160708
PL  - England
TA  - Allergol Int
JT  - Allergology international : official journal of the Japanese Society of 
      Allergology
JID - 9616296
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-B*15:02 antigen)
RN  - 0 (HLA-B*58:01 antigen)
RN  - 0 (HLA-B15 Antigen)
RN  - 0 (Sulfonamides)
RN  - 33CM23913M (Carbamazepine)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - Allopurinol/*therapeutic use
MH  - Carbamazepine/*therapeutic use
MH  - Female
MH  - HLA-B Antigens/*immunology
MH  - HLA-B15 Antigen/*immunology
MH  - Humans
MH  - Japan/epidemiology
MH  - Male
MH  - *Stevens-Johnson Syndrome/diet therapy/epidemiology/immunology/pathology
MH  - Sulfonamides/*therapeutic use
OTO - NOTNLM
OT  - Corticosteroids
OT  - Intravenous immunoglobulin therapy
OT  - Japanese
OT  - Stevens-Johnson syndrome
OT  - Toxic epidermal necrolysis
EDAT- 2016/07/13 06:00
MHDA- 2017/01/24 06:00
CRDT- 2016/07/13 06:00
PHST- 2016/03/17 00:00 [received]
PHST- 2016/05/11 00:00 [revised]
PHST- 2016/05/15 00:00 [accepted]
PHST- 2016/07/13 06:00 [pubmed]
PHST- 2017/01/24 06:00 [medline]
PHST- 2016/07/13 06:00 [entrez]
AID - S1323-8930(16)30066-1 [pii]
AID - 10.1016/j.alit.2016.06.001 [doi]
PST - ppublish
SO  - Allergol Int. 2017 Jan;66(1):36-41. doi: 10.1016/j.alit.2016.06.001. Epub 2016 
      Jul 8.