Toxic epidermal necrosis - 독성표피괴사 융해증
독성표피괴사 융해증 (Toxic epidermal necrosis)의 특징적인 피부 손실
relevance score : -100.0%
ReferencesStevens-Johnson Syndrome (SJS) 및 Toxic Epidermal Necrolysis (TEN)은 피부가 광범위하게 괴사하고 탈락하는 드문 질환입니다. 치료 측면에서 사이클로스포린은 SJS에 매우 효과적이며, 정맥내 면역글로불린(IVIg)과 코르티코스테로이드의 병용요법이 SJS 및 TEN에 가장 효과적입니다.
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)은 특정 약물과 면역 체계의 반응으로 발생하는 심각한 피부 반응으로, 표피가 대규모로 박리되어 신체 표면의 30% 이상에 영향을 미칩니다. TEN의 사망률은 20%를 초과하며, 주로 감염과 호흡 곤란이 원인이 됩니다. 유발 약물을 즉시 중단하고 지지 요법을 제공하며, 추가 치료를 병행하면 예후가 개선될 수 있습니다. 최근 연구에 따르면 무작위 대조 시험 및 여러 메타‑분석 결과, Cyclosporine(사이클로스포린), TNF‑alpha inhibitor(종양 괴사 인자 알파 억제제), Intravenous immunoglobulin(정맥 내 면역 글로불린)과 corticosteroid(코르티코스테로이드)의 조합이 도움이 될 수 있는 것으로 나타났습니다.
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.
가장 흔한 원인은 라모트리진 (lamotrigine), 카르바마제핀 (carbamazepine), 알로푸리놀 (allopurinol), 설폰아미드 항생제 (sulfonamide antibiotics), 네비라핀 (nevirapine) 등 특정 약물입니다. 위험 요인으로는 HIV 감염과 전신홍반루푸스가 있습니다. 치료는 주로 화상병동이나 중환자실 등 병원에서 이루어집니다.
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이 질환은 매우 심각하므로 입술·구강이 영향을 받거나 피부에 물집이 생기면 즉시 의료진의 진료를 받아야 합니다.
의심되는 약물은 즉시 중단해야 합니다. (예: 항생제, 비스테로이드성 항염증제)