Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Int Med Res. 2024 Jan;52(1):3000605231223059. doi: 10.1177/03000605231223059.
Toxic epidermal necrolysis (TEN) is a rare severe cutaneous adverse reaction that involves more than 30% of the body surface area. TEN can be accompanied by a series of systemic symptoms and has a high risk of death. Tumor necrosis factor (TNF)-α inhibitors such as adalimumab and etanercept have been shown to be safe and effective for the treatment of TEN in some cases. However, clinical data on the use of TNF-α inhibitors to treat TEN with severe systemic infection are scarce. In the present study, three adult patients who developed TEN with serious active infection were successfully treated with etanercept. One of the three patients had active open pulmonary tuberculosis, and the other two had septicemia and/or fungal sepsis. All patients' skin lesions significantly improved after several days, and none of the patients developed emerging or re-emerging infectious diseases, adverse reactions, or a similar rash during follow-up. TNF-α inhibitors may be an effective treatment choice for TEN with severe systemic infection. However, further studies with large samples are still required for validation because clinical experience is limited.
中毒性表皮坏死松解症（TEN）是一种罕见的严重皮肤不良反应，涉及超过 30%的体表面积。TEN 可伴有一系列全身症状，且死亡风险较高。肿瘤坏死因子（TNF）-α抑制剂，如阿达木单抗和依那西普，在某些情况下已被证明对 TEN 的治疗安全且有效。然而，临床上使用 TNF-α抑制剂治疗伴有严重全身感染的 TEN 的数据较少。本研究中，3 例严重活动性感染导致 TEN 的成年患者成功接受了依那西普治疗。其中 1 例患者患有活动性开放性肺结核，另外 2 例患者患有败血症和/或真菌感染性败血症。所有患者的皮肤损伤在数天后明显改善，在随访期间，没有患者出现新发或再发传染病、不良反应或类似皮疹。TNF-α抑制剂可能是治疗伴有严重全身感染的 TEN 的有效治疗选择。然而，由于临床经验有限，仍需要进一步进行大样本研究来验证。
