Department of Dermatology, Singapore General Hospital Singapore, Singapore.
Allergy Centre, Singapore General Hospital Singapore, Singapore.
Expert Opin Drug Saf. 2022 Aug;21(8):1039-1046. doi: 10.1080/14740338.2022.2106367. Epub 2022 Aug 1.
Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening adverse drug reactions that are collectively known as epidermal necrolysis. The abrupt detachment of the skin and mucositis results in systemic complications such as fluid and electrolyte disturbances, hypothermia, sepsis, organ failure, and death. Management is multidisciplinary and complex.
This present article reviews the principles and best practices in the care of patients with epidermal necrolysis. These include having prompt admissions to optimal care facilities, coordinated specialized care during the acute phase, as well as long-term follow-up to manage chronic sequelae.
Patients with epidermal necrolysis should be managed in specialized/reference centers that are experienced with the management of the disease. Multi-disciplinary supportive care remains the cornerstone. Current evidence precludes definitive recommendation on any immunomodulatory agent as treatment. Long-term follow-up is required in order to diagnose and treat any chronic sequelae.
史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症是严重的、危及生命的药物不良反应,统称为表皮坏死松解症。皮肤和黏膜的突然脱落会导致液体和电解质紊乱、低体温、脓毒症、器官衰竭和死亡等全身并发症。治疗需要多学科和复杂的方法。
本文综述了表皮坏死松解症患者护理的原则和最佳实践。这些原则包括及时入住最佳护理机构、在急性阶段进行协调的专门护理,以及进行长期随访以管理慢性后遗症。
患有表皮坏死松解症的患者应在具有该病管理经验的专门/参考中心进行治疗。多学科支持性护理仍然是基石。目前的证据不能明确推荐任何免疫调节剂作为治疗药物。需要进行长期随访,以便诊断和治疗任何慢性后遗症。