Ruiz-Maldonado R
J Am Acad Dermatol. 1985 Oct;13(4):623-35. doi: 10.1016/s0190-9622(85)70207-1.
Sixty patients with acute disseminated epidermal necrosis (ADEN) were hospitalized and carefully studied. They included thirty-nine patients with drug-associated Stevens-Johnson syndrome, five patients with drug-associated Lyell's syndrome, and sixteen patients with transitional ADEN. On the basis of growing evidence of an association between erythema multiforme major and drugs and between Lyell's syndrome and drugs, and because of the existence of transitional cases, a unitary hypothesis for this group of cases is proposed. Considering the lack of precise definitions and the confusing current terminology, we define and propose the following terms: ADEN type 1 for drug-associated Stevens-Johnson syndrome, ADEN type 2 for drug-associated transitional cases, and ADEN type 3 for drug-associated toxic epidermal necrolysis, or Lyell's syndrome. The most frequent underlying diseases in our patients were seizures, and the most frequently suspected cause of ADEN was the use of anticonvulsants. All our patients were treated with supportive therapy; none received corticosteroids. The general mortality rate was 15%. The recognition of ADEN type 2 (transitional) has important prognostic and therapeutic implications.
60例急性播散性表皮坏死（ADEN）患者入院并接受了仔细研究。其中包括39例药物相关性史蒂文斯-约翰逊综合征患者、5例药物相关性莱尔综合征患者和16例过渡型ADEN患者。基于多形性红斑重症与药物之间以及莱尔综合征与药物之间关联的证据不断增加，并且由于存在过渡病例，针对这组病例提出了一个统一假说。考虑到缺乏精确的定义以及当前术语的混乱，我们定义并提出以下术语：药物相关性史蒂文斯-约翰逊综合征为ADEN 1型，药物相关性过渡病例为ADEN 2型，药物相关性中毒性表皮坏死松解症或莱尔综合征为ADEN 3型。我们患者中最常见的基础疾病是癫痫发作，ADEN最常怀疑的病因是使用抗惊厥药。所有患者均接受了支持治疗；无人接受皮质类固醇治疗。总体死亡率为15%。认识到ADEN 2型（过渡型）具有重要的预后和治疗意义。
