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史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症:一家地区烧伤中心15年的经验。

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 15-year Regional Burn Center Experience.

作者信息

Obed Dima, Salim Mustafa, Dastagir Khaled, Krezdorn Nicco, Obed Doha, Vogt Peter M

机构信息

Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.

Department of Human Genetics, Hannover Medical School, Hannover, Germany.

出版信息

JPRAS Open. 2025 Feb 8;44:83-92. doi: 10.1016/j.jpra.2025.02.003. eCollection 2025 Jun.

DOI:10.1016/j.jpra.2025.02.003
PMID:40143959
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11938068/
Abstract

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) constitute rare and potentially life-threatening dermal hypersensitivity reactions marked by epidermal necrosis and skin blistering. They present a substantial health care burden and challenge to burn units. To advance our understanding of TEN/SJS and the patient cohort at risk for mortality, we hereby report our long-term experience in the management of patients with TEN/SJS. For this purpose, intensive care patients with TEN/SJS admitted between 2007 and 2022 to a single major burn unit in Germany were assessed. Clinical, demographic, and mortality data were collected and examined. A total of 92 patients were included. Mortality was 46.7%, with non-survivors being significantly older, more frequently women, and having markedly higher percentages of the total body surface area (TBSA) affected. The mean age was 63 years and mean percentage of affected TBSA was 52%. The most frequent culprit drugs that caused TEN/SJS were allopurinol and metamizole, followed by various antibiotics. In 5.4% of the cases, no TEN/SJS-inducing suspect drug was identified. TEN/SJS present severe adverse cutaneous reactions that are marked by high in-hospital mortality rates. Age and TBSA were associated with poor prognosis. The range of possible trigger drugs that were associated with TEN/SJS was in agreement with previous reports.

摘要

中毒性表皮坏死松解症(TEN)和史蒂文斯-约翰逊综合征(SJS)是罕见的、可能危及生命的皮肤超敏反应,其特征为表皮坏死和皮肤水疱形成。它们给烧伤科带来了沉重的医疗负担和挑战。为了增进我们对TEN/SJS以及有死亡风险患者群体的了解,我们在此报告我们在TEN/SJS患者管理方面的长期经验。为此,我们评估了2007年至2022年间入住德国一家大型烧伤科的TEN/SJS重症监护患者。收集并检查了临床、人口统计学和死亡率数据。共纳入92例患者。死亡率为46.7%,非幸存者年龄显著更大,女性更常见,且全身表面积(TBSA)受累百分比明显更高。平均年龄为63岁,TBSA受累的平均百分比为52%。导致TEN/SJS最常见的可疑药物是别嘌醇和安乃近,其次是各种抗生素。在5.4%的病例中,未确定导致TEN/SJS的可疑药物。TEN/SJS表现为严重的不良皮肤反应,其特征是住院死亡率高。年龄和TBSA与预后不良有关。与TEN/SJS相关的可能引发药物范围与先前报告一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/42e8d693d752/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/6635c387b82e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/763da1107e41/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/bfbc1a8a36d2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/42e8d693d752/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/6635c387b82e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/763da1107e41/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/bfbc1a8a36d2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/11938068/42e8d693d752/gr4.jpg

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本文引用的文献

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Recent progress in Stevens-Johnson syndrome/toxic epidermal necrolysis: diagnostic criteria, pathogenesis and treatment.史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症的最新进展:诊断标准、发病机制与治疗
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Dipyrone (Metamizole)-Induced Stevens-Johnson Syndrome.安乃近诱导的史蒂文斯-约翰逊综合征。
Cureus. 2024 Jan 28;16(1):e53122. doi: 10.7759/cureus.53122. eCollection 2024 Jan.
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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: 11-year Demographic Clinical and Prognostic Characteristics.
史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症:11年的人口统计学、临床及预后特征
Indian J Dermatol. 2022 Jan-Feb;67(1):12-18. doi: 10.4103/ijd.IJD_671_21.
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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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Mycoplasma-induced Stevens-Johnson syndrome/toxic epidermal necrolysis: Case-control analysis of a cohort managed in a specialized center.支原体诱发的史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症:在一家专业中心管理的队列病例对照分析
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Metamizole-induced reactions as a paradigm of drug hypersensitivity: Non-allergic reactions, anaphylaxis, and delayed-type allergy.安乃近诱导的反应作为药物超敏反应的范例:非过敏反应、过敏反应和迟发型过敏。
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