Toxic epidermal necrolysis (TEN) is a type of severe skin reaction. Together with Stevens–Johnson syndrome (SJS) it forms a spectrum of disease, with TEN being more severe. Early symptoms include fever and flu-like symptoms. A few days later the skin begins to blister and peel forming painful raw areas. Mucous membranes, such as the mouth, are also typically involved. Complications include dehydration, sepsis, pneumonia, and multiple organ failure.
Stevens-Johnson Syndrome (SJS) 和 Toxic Epidermal Necrolysis (TEN) 是皮膚出現大面積壞死和脫落的罕見情況。在治療方面,環孢素對 SJS 非常有效,而靜脈注射免疫球蛋白 (IVIg) 和皮質類固醇的組合對於 SJS 和 TEN 病例效果最好。 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) 是某些藥物和免疫系統活動引起的嚴重皮膚反應,導致外皮膚層(表皮)大規模脫離,影響身體表面30%以上。 TEN 的死亡率超過 20%,通常是由於感染和呼吸困難造成的。停止引起反應的藥物、提供支持性護理以及使用額外的治療可以改善結果。最近的研究表明,基於隨機對照試驗和多項研究的分析,環孢素、腫瘤壞死因子α抑制劑以及靜脈注射免疫球蛋白和皮質類固醇的組合等藥物可能會有所幫助。 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.
最常見的原因是某些藥物,如拉莫三嗪、卡馬西平、別嘌呤醇、磺胺類抗生素和奈韋拉平。危險因子包括愛滋病毒和系統性紅斑狼瘡。治療通常在醫院進行,例如燒傷科或重症監護室。
○ 治療
這是一種嚴重的疾病,因此如果您的嘴唇或嘴巴受到影響或皮膚起水泡,請盡快去看醫生。
可疑藥物應停止使用。 (例如抗生素、非類固醇抗發炎藥)