Health Services Research Unit, IDI-IRCCS, Rome, Italy.
Health Services Research Unit, IDI-IRCCS, Rome, Italy.
J Am Acad Dermatol. 2014 Aug;71(2):278-83. doi: 10.1016/j.jaad.2014.04.044. Epub 2014 Jun 11.
Toxic epidermal necrolysis (TEN) is a severe and potentially lethal drug reaction for which no standard treatment is available.
To describe a case series of patients with TEN treated with a single dose of etanercept.
We observed 10 consecutive patients with TEN. For each patient, we recorded the presence of comorbidities and all the drugs recently started (ie, in the last month). In all cases, 50 mg of etanercept was administered in a single subcutaneous injection. The clinical severity of disease was computed using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Using the probabilities of death linked to each level of SCORTEN score, we calculated the expected probability of death in our patients. Healing was defined as complete reepithelialization, and a time to healing curve was then obtained using the Kaplan-Meier method.
All patients promptly responded to treatment, reaching complete reepithelialization without complications or side effects. The median time to healing was 8.5 days.
This is a small, uncontrolled case series.
These preliminary results suggest the possibility that tumor necrosis factor-alfa may be an effective target for control of TEN, a dangerous skin condition for which no effective cure has yet been found.
中毒性表皮坏死松解症（TEN）是一种严重且潜在致命的药物反应，目前尚无标准治疗方法。
描述一组接受依那西普单次剂量治疗的 TEN 患者的病例系列。
我们观察了 10 例连续的 TEN 患者。对于每位患者，我们记录了合并症的存在情况以及最近开始使用的所有药物（即在过去一个月内）。在所有情况下，均给予 50mg 依那西普单次皮下注射。使用毒性表皮坏死评分（SCORTEN）量表计算疾病的临床严重程度。根据与 SCORTEN 评分每个水平相关的死亡概率，我们计算了我们患者的预期死亡概率。愈合定义为完全再上皮化，并使用 Kaplan-Meier 方法获得愈合时间曲线。
所有患者均迅速对治疗产生反应，无并发症或副作用，完全再上皮化。中位愈合时间为 8.5 天。
这是一项小型、非对照的病例系列研究。
这些初步结果表明，肿瘤坏死因子-α可能是控制 TEN 的有效靶点，TEN 是一种危险的皮肤疾病，目前尚无有效的治疗方法。
