Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Expert Rev Clin Immunol. 2020 Mar;16(3):285-291. doi: 10.1080/1744666X.2020.1729128. Epub 2020 Feb 28.
: 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.
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。