PMID- 36118413
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220920
IS  - 2059-5131 (Electronic)
IS  - 2059-5131 (Linking)
VI  - 8
DP  - 2022 Jan-Dec
TI  - A contemporary snippet on clinical presentation and management of toxic epidermal 
      necrolysis.
PG  - 20595131221122381
LID - 10.1177/20595131221122381 [doi]
LID - 20595131221122381
AB  - INTRODUCTION: Toxic epidermal necrolysis (TEN) is one of the most severe 
      cutaneous adverse reactions with a mortality rate of 30%. Due to a lack of 
      consensus regarding the treatment and management of TEN, therapy is 
      individualized on a case-to-case basis. PURPOSE: The scientific literature about 
      Stevens-Johnson Syndrome (SJS) and TEN is summarized and assessed to aid and 
      assist in determining the optimal course of treatment. METHODS: PubMed and Google 
      Scholar, among others, were searched with the keywords: "Toxic Epidermal 
      Necrolysis", "corticosteroids", "cyclosporine", "etanercept", "intravenous 
      immunoglobulin", "Stevens-Johnson syndrome" and filtered by year. The research 
      articles generated by the search, and their references, were reviewed. RESULTS: 
      TEN is a severe dermatological condition that is mainly caused by medicines. 
      World-wide guidelines differ in care plans. As there is no consensus on the 
      management of TEN, this article aims to summarize the efficacy and feasibility of 
      the management aspect of TEN from previous studies. Supportive care is highly 
      accepted, along with early discontinuation of all medicines (hydration & 
      electrolytes). Corticosteroids and cyclosporine have been used in therapy. 
      Intravenous immunoglobulin (IVIG) is currently being administered; however, their 
      efficacy by themselves and in combination remains uncertain. CONCLUSION: Current 
      evidence predominantly from retrospective studies suggests no individual 
      treatment has sufficient efficacy and a multi-faceted regimen stands to be 
      favored. Therapeutic regimens from corticosteroids to IVIG are under constant 
      evaluation. The life-threatening nature of TEN warrants further confirmation with 
      more extensive, robust randomized, controlled trials. LAY SUMMARY: Toxic 
      epidermal necrolysis (TEN) is a serious skin reaction with a 30% chance of 
      mortality. Commonly TEN is caused by medicines and results in a burn like 
      appearance and sensation in patients. Usually administered medicine is cleared 
      effectively by the human body but when the clearance of few metabolites from 
      medicine is disrupted due to few genes, it leads to an ominous response by the 
      body. This response involves several intermediate chemicals that primarily attack 
      skin cells. Treatment guidelines differ globally. Supportive care is highly 
      accepted, along with early discontinuation of all medicine. Currently, a 
      multi-faceted treatment regimen is favored. Treatments like corticosteroids to 
      immunoglobulins are under constant evaluation. Identification of the perfect 
      combination of treatment needs confirmation from robust randomized controlled 
      trials.
CI  - (c) The Author(s) 2022.
FAU - Naik, Piyu Parth
AU  - Naik PP
AUID- ORCID: 0000-0002-6499-4062
AD  - Department of Dermatology, Saudi German Hospital and Clinic, Dubai, United Arab 
      Emirates. RINGGOLD: 432862
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220913
PL  - United States
TA  - Scars Burn Heal
JT  - Scars, burns & healing
JID - 101718377
PMC - PMC9476246
OTO - NOTNLM
OT  - Corticosteroids
OT  - Stevens-Johnson syndrome
OT  - immunoglobulin
OT  - toxic epidermal necrolysis
COIS- Declaration of conflicting interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2022/09/20 06:00
MHDA- 2022/09/20 06:01
PMCR- 2022/09/13
CRDT- 2022/09/19 04:11
PHST- 2022/09/19 04:11 [entrez]
PHST- 2022/09/20 06:00 [pubmed]
PHST- 2022/09/20 06:01 [medline]
PHST- 2022/09/13 00:00 [pmc-release]
AID - 10.1177_20595131221122381 [pii]
AID - 10.1177/20595131221122381 [doi]
PST - epublish
SO  - Scars Burn Heal. 2022 Sep 13;8:20595131221122381. doi: 10.1177/20595131221122381. 
      eCollection 2022 Jan-Dec.