Toxic epidermal necrosis
Toxic epidermal necrosis の特徴的な皮膚喪失
References
Stevens-Johnson Syndrome (SJS) および Toxic Epidermal Necrolysis (TEN) は、皮膚が広範な壊死と脱落を経験するまれな症状です。治療に関しては、シクロスポリンは SJS に対して非常に効果的ですが、静脈内免疫グロブリン (IVIg) とコルチコステロイドの組み合わせは SJS と TEN の場合に最も効果的です。
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN.
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN.
Toxic epidermal necrolysis (TEN) は、特定の薬剤や免疫系の活動によって引き起こされる重篤な皮膚反応であり、その結果、外側の皮膚層 (表皮) が大規模に剥離し、体表面の 30% 以上に影響を及ぼします。 TEN の死亡率は 20% 以上で、感染症や呼吸困難が原因となることがよくあります。反応を引き起こしている薬剤の使用を中止し、支持療法を提供し、追加の治療法を使用することで、結果を改善できる可能性があります。最近の研究では、ランダム化比較試験や複数の研究の分析に基づいて、シクロスポリン、腫瘍壊死因子α阻害剤、静脈内免疫グロブリンとコルチコステロイドの組み合わせなどの薬剤が役立つ可能性があることが示されています。
Toxic epidermal necrolysis (TEN) is a serious skin reaction caused by certain medications and immune system activity, resulting in large-scale detachment of the outer skin layer (epidermis), affecting more than 30% of the body's surface. TEN has a mortality rate of over 20%, often due to infections and breathing difficulties. Stopping the medication causing the reaction, providing supportive care, and using additional treatments can improve the outcome. Recent studies have shown that drugs like cyclosporine, tumor necrosis factor alpha inhibitors, and a combination of intravenous immune globulin and corticosteroids can be helpful, based on randomized controlled trials and analyses of multiple studies.
Toxic epidermal necrolysis (TEN) is a serious skin reaction caused by certain medications and immune system activity, resulting in large-scale detachment of the outer skin layer (epidermis), affecting more than 30% of the body's surface. TEN has a mortality rate of over 20%, often due to infections and breathing difficulties. Stopping the medication causing the reaction, providing supportive care, and using additional treatments can improve the outcome. Recent studies have shown that drugs like cyclosporine, tumor necrosis factor alpha inhibitors, and a combination of intravenous immune globulin and corticosteroids can be helpful, based on randomized controlled trials and analyses of multiple studies.
Recent Advances: There is improved understanding of pain and morbidity with regard to the type and frequency of dressing changes. More modern dressings, such as nanocrystalline, are currently favored as they may be kept in situ for longer periods. The most recent evidence on systemic agents, such as corticosteroids and cyclosporine, and novel treatments, are also discussed.
最も一般的な原因は、ラモトリギン、カルバマゼピン、アロプリノール、スルホンアミド系抗生物質、ネビラピンなどの特定の薬剤です。危険因子には、HIV および全身性エリテマトーデスが含まれます。治療は通常、熱傷病棟や集中治療室などの病院で行われます。
○ 処理
これは重篤な病気ですので、唇や口に影響が出たり、皮膚に水疱ができたりした場合は、できるだけ早く医師の診察を受けてください。
疑わしい薬物は中止する必要があります。 （例：抗生物質、非ステロイド性抗炎症薬）