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史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症伴严重眼部并发症。

Stevens-Johnson syndrome/toxic epidermal necrolysis with severe ocular complications.

机构信息

Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Expert Rev Clin Immunol. 2020 Mar;16(3):285-291. doi: 10.1080/1744666X.2020.1729128. Epub 2020 Feb 28.

Abstract

: Stevens-Johnson syndrome (SJS) and its severe phenotype, toxic epidermal necrolysis (TEN), are acute inflammatory vesiculobullous reactions of the skin and mucosa. Approximately 50% of SJS/TEN patients diagnosed by dermatologists and in burn units suffer from severe ocular complications (SOC) in the acute stage.: Earlier studies on patients with SJS/TEN with SOC identified cold medicines including multi-ingredient cold medications and non-steroidal anti-inflammatory drugs as the main eliciting drugs. HLA analyzes showed that genetic predisposition might play a role in the response to these drugs. Our analysis of the association between HLA genotypes and cold medicine-related SJS/TEN (CM-SJS/TEN) with SOC revealed that certain HLA genotypes play a role in the development of SJS/TEN with SOC. Genetic predisposition and other factors contributing to the elicitation of CM-SJS/TEN with SOC and the management of patients in the acute and chronic stage of the disease are discussed.: The main sequelae of SJS/TEN are ocular sequelae with visual disturbance. SJS/TEN with SOC needs ophthalmic treatment in addition to systemic treatment from the onset time to reduce the ophthalmic sequelae. In addition, HLA examination and public awareness of SJS/TEN with SOC due to cold medicine use might contribute to preventing visual disturbance due to SJS/TEN. SJS: Stevens-Johnson syndrome; TEN: toxic epidermal necrolysis; SOC: severe ocular complications.

摘要

史蒂文斯-约翰逊综合征(SJS)及其严重表型中毒性表皮坏死松解症(TEN)是皮肤和黏膜的急性炎症性水疱性反应。约有 50%的皮肤科和烧伤科诊断为 SJS/TEN 的患者在急性期会出现严重的眼部并发症(SOC)。:早期对有 SOC 的 SJS/TEN 患者的研究发现,感冒药(包括多种成分的感冒药和非甾体抗炎药)是主要的诱发药物。HLA 分析表明,遗传易感性可能在对这些药物的反应中起作用。我们对与 SOC 相关的 HLA 基因型与冷药相关的 SJS/TEN(CM-SJS/TEN)之间的关联进行了分析,结果表明某些 HLA 基因型在 SOC 相关的 SJS/TEN 的发展中起作用。遗传易感性和其他因素导致 SOC 相关的 CM-SJS/TEN 的诱发以及疾病急性和慢性阶段的患者管理进行了讨论。:SJS/TEN 的主要后遗症是伴有视力障碍的眼部后遗症。从发病开始,SJS/TEN 伴有 SOC 就需要进行眼部治疗和全身治疗,以减少眼部后遗症。此外,由于使用感冒药导致的 HLA 检查和对 SOC 相关 SJS/TEN 的公众意识可能有助于预防因 SJS/TEN 引起的视力障碍。SJS:史蒂文斯-约翰逊综合征;TEN:中毒性表皮坏死松解症;SOC:严重眼部并发症。

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