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To Debride or Not to Debride: A Review of Wound Management for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.清创还是不清创：史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症伤口处理的综述
Cureus. 2024 Mar 1;16(3):e55350. doi: 10.7759/cureus.55350. eCollection 2024 Mar.
2
Improving mortality outcomes of Stevens Johnson syndrome/toxic epidermal necrolysis: A regional burns centre experience.改善史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症的死亡率：一家地区烧伤中心的经验
Burns. 2018 May;44(3):603-611. doi: 10.1016/j.burns.2017.09.015. Epub 2017 Oct 10.
3
Stevens-Johnson syndrome and toxic epidermal necrolysis: a 10-year experience in a burns unit.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：烧伤科 10 年经验。
J Wound Care. 2021 Jun 2;30(6):492-496. doi: 10.12968/jowc.2021.30.6.492.
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Antishear Therapy for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Follow-up Study.抗剪切治疗 Stevens-Johnson 综合征和中毒性表皮坏死松解症：一项随访研究。
J Burn Care Res. 2021 Nov 24;42(6):1152-1161. doi: 10.1093/jbcr/irab155.
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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Concise Review with a Comprehensive Summary of Therapeutic Interventions Emphasizing Supportive Measures.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：一篇简要综述，全面总结治疗干预措施，重点强调支持性措施
Adv Ther. 2017 Jun;34(6):1235-1244. doi: 10.1007/s12325-017-0530-y. Epub 2017 Apr 24.
6
Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的最新观点。
Clin Rev Allergy Immunol. 2018 Feb;54(1):147-176. doi: 10.1007/s12016-017-8654-z.
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A Compilation of Drug Etiologies of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的药物病因汇编。
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Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults.皮肤科住院医师协会关于成人史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症管理的支持性护理指南。
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Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：系统评价和荟萃分析。
J Wound Care. 2021 Dec 2;30(12):1012-1019. doi: 10.12968/jowc.2021.30.12.1012.
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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the Era of Systems Medicine.系统医学时代的史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症。
Methods Mol Biol. 2022;2486:37-54. doi: 10.1007/978-1-0716-2265-0_3.

引用本文的文献

1
Case report: Toxic epidermal necrolysis induced by tislelizumab in a patient with esophageal squamous cell carcinoma.病例报告：替雷利珠单抗诱导食管鳞状细胞癌患者发生中毒性表皮坏死松解症。
Front Med (Lausanne). 2024 Dec 23;11:1522525. doi: 10.3389/fmed.2024.1522525. eCollection 2024.
2
Update on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Diagnosis and Management.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的最新进展：诊断与治疗。
Am J Clin Dermatol. 2024 Nov;25(6):891-908. doi: 10.1007/s40257-024-00889-6. Epub 2024 Sep 15.

本文引用的文献

1
Stevens-Johnson syndrome and toxic epidermal necrolysis: retrospective review of 10-year experience.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：10 年回顾性研究。
Int J Dermatol. 2019 Sep;58(9):1069-1077. doi: 10.1111/ijd.14409. Epub 2019 Mar 1.
2
Corrigendum to "The Epidemiology of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in China".《中国史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的流行病学》勘误
J Immunol Res. 2018 Jun 28;2018:4154507. doi: 10.1155/2018/4154507. eCollection 2018.
3
Treatment of toxic epidermal necrolysis by a multidisciplinary team. A review of literature and treatment results.多学科团队治疗中毒性表皮坏死松解症。文献综述与治疗结果
Burns. 2018 Jun;44(4):807-815. doi: 10.1016/j.burns.2017.10.022. Epub 2018 Apr 4.
4
Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的最新观点。
Clin Rev Allergy Immunol. 2018 Feb;54(1):147-176. doi: 10.1007/s12016-017-8654-z.
5
Improving mortality outcomes of Stevens Johnson syndrome/toxic epidermal necrolysis: A regional burns centre experience.改善史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症的死亡率：一家地区烧伤中心的经验
Burns. 2018 May;44(3):603-611. doi: 10.1016/j.burns.2017.09.015. Epub 2017 Oct 10.
6
Burn Center Care of Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症患者的烧伤中心护理
Clin Plast Surg. 2017 Jul;44(3):583-595. doi: 10.1016/j.cps.2017.02.016.
7
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Concise Review with a Comprehensive Summary of Therapeutic Interventions Emphasizing Supportive Measures.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：一篇简要综述，全面总结治疗干预措施，重点强调支持性措施
Adv Ther. 2017 Jun;34(6):1235-1244. doi: 10.1007/s12325-017-0530-y. Epub 2017 Apr 24.
8
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Associations, Outcomes, and Pathobiology-Thirty Years of Progress but Still Much to Be Done.史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：关联、结局与病理生物学——三十年的进展但仍有许多工作要做
J Invest Dermatol. 2017 May;137(5):1004-1008. doi: 10.1016/j.jid.2017.01.003.
9
Guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis: An Indian perspective.史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症管理指南：印度视角
Indian J Dermatol Venereol Leprol. 2016 Nov-Dec;82(6):603-625. doi: 10.4103/0378-6323.191134.
10
Steven Johnson Syndrome and Toxic Epidermal Necrolysis in a burn unit: A 15-year experience.烧伤病房中的史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症：15年经验
Burns. 2017 Feb;43(1):200-205. doi: 10.1016/j.burns.2016.07.026. Epub 2016 Aug 21.

清创还是不清创：史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症伤口处理的综述

To Debride or Not to Debride: A Review of Wound Management for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

作者信息

Enescu Christina D, Elder Adam J, Deirawan Hany, Moossavi Meena

机构信息

Department of Dermatology, Wayne State University School of Medicine, Detroit, USA.

Department of Medical Education, Wayne State University School of Medicine, Detroit, USA.

出版信息

Cureus. 2024 Mar 1;16(3):e55350. doi: 10.7759/cureus.55350. eCollection 2024 Mar.

DOI:10.7759/cureus.55350
PMID:38559535
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10981949/
Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-mediated skin reactions with high mortality as a result of severely compromised skin barrier function. Currently, there is no consensus on the topical management of these conditions. Some advocate for surgical debridement of affected skin as a means of preventing infection and facilitating reepithelialization with synthetic and biological wound coverage. Others prefer a conservative approach that relies on leaving the blistered skin in situ. A consensus is lacking, primarily due to the rarity of the disease and the lack of high-quality evidence supporting one particular form of management. The goal of this review is to explore and compare the two treatment approaches for SJS and TEN, namely conservative management and surgical debridement.

摘要

史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是免疫介导的皮肤反应，由于皮肤屏障功能严重受损，死亡率很高。目前，对于这些病症的局部治疗尚无共识。一些人主张对受影响的皮肤进行手术清创，以预防感染并通过合成和生物伤口覆盖促进上皮再形成。另一些人则倾向于采用保守方法，即让水疱皮肤保持原位。目前缺乏共识，主要是因为这种疾病罕见，且缺乏支持某一种特定治疗方式的高质量证据。本综述的目的是探讨和比较SJS和TEN的两种治疗方法，即保守治疗和手术清创。