PMID- 32595945
OWN - NLM
STAT- MEDLINE
DCOM- 20201029
LR  - 20201029
IS  - 2046-1402 (Electronic)
IS  - 2046-1402 (Linking)
VI  - 9
DP  - 2020
TI  - Recent advances in managing and understanding Stevens-Johnson syndrome and toxic 
      epidermal necrolysis.
LID - F1000 Faculty Rev-612 [pii]
LID - 10.12688/f1000research.24748.1 [doi]
AB  - Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are 
      life-threatening diseases characterized by detachment of the epidermis and mucous 
      membrane. SJS/TEN are considered to be on the same spectrum of diseases with 
      different severities. They are classified by the percentage of skin detachment 
      area. SJS/TEN can also cause several complications in the liver, kidneys, and 
      respiratory tract. The pathogenesis of SJS/TEN is still unclear. Although it is 
      difficult to diagnose early stage SJS/TEN, biomarkers for diagnosis or severity 
      prediction have not been well established. Furthermore, optimal therapeutic 
      options for SJS/TEN are still controversial. Several drugs, such as carbamazepine 
      and allopurinol, are reported to have a strong relationship with a specific human 
      leukocyte antigen (HLA) type. This relationship differs between different 
      ethnicities. Recently, the usefulness of HLA screening before administering 
      specific drugs to decrease the incidence of SJS/TEN has been investigated. Skin 
      detachment in SJS/TEN skin lesions is caused by extensive epidermal cell death, 
      which has been considered to be apoptosis via the Fas-FasL pathway or 
      perforin/granzyme pathway. We reported that necroptosis, i.e. programmed 
      necrosis, also contributes to epidermal cell death. Annexin A1, released from 
      monocytes, and its interaction with the formyl peptide receptor 1 induce 
      necroptosis. Several diagnostic or prognostic biomarkers for SJS/TEN have been 
      reported, such as CCL-27, IL-15, galectin-7, and RIP3. Supportive care is 
      recommended for the treatment of SJS/TEN. However, optimal therapeutic options 
      such as systemic corticosteroids, intravenous immunoglobulin, cyclosporine, and 
      TNF-alpha antagonists are still controversial. Recently, the beneficial effects of 
      cyclosporine and TNF-alpha antagonists have been explored. In this review, we discuss 
      recent advances in the pathophysiology and management of SJS/TEN.
CI  - Copyright: (c) 2020 Hasegawa A and Abe R.
FAU - Hasegawa, Akito
AU  - Hasegawa A
AUID- ORCID: 0000-0002-7606-5551
AD  - Division of Dermatology, Niigata University Graduate School of Medical and Dental 
      Sciences, Niigata, Japan.
FAU - Abe, Riichiro
AU  - Abe R
AD  - Division of Dermatology, Niigata University Graduate School of Medical and Dental 
      Sciences, Niigata, Japan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200616
PL  - England
TA  - F1000Res
JT  - F1000Research
JID - 101594320
SB  - IM
MH  - Apoptosis
MH  - Epidermis
MH  - Humans
MH  - Necrosis
MH  - *Stevens-Johnson Syndrome/diagnosis/drug therapy/etiology
PMC - PMC7308994
OTO - NOTNLM
OT  - Stevens-Johnson syndrome
OT  - drug reaction
OT  - erythema multiforme
OT  - necroptosis
OT  - toxic epidermal necrolysis
COIS- No competing interests were disclosed.No competing interests were disclosed.No 
      competing interests were disclosed.
EDAT- 2020/07/01 06:00
MHDA- 2020/10/30 06:00
PMCR- 2020/06/16
CRDT- 2020/06/30 06:00
PHST- 2020/06/10 00:00 [accepted]
PHST- 2020/06/30 06:00 [entrez]
PHST- 2020/07/01 06:00 [pubmed]
PHST- 2020/10/30 06:00 [medline]
PHST- 2020/06/16 00:00 [pmc-release]
AID - F1000 Faculty Rev-612 [pii]
AID - 10.12688/f1000research.24748.1 [doi]
PST - epublish
SO  - F1000Res. 2020 Jun 16;9:F1000 Faculty Rev-612. doi: 
      10.12688/f1000research.24748.1. eCollection 2020.