Abstract:
Toxic epidermal necrolysis (TEN) is an immune mediated, severe cutaneous adverse drug reaction characterized by epidermal detachment affecting greater than 30% body surface area. The mortality rate of TEN exceeds 20% and is usually caused by infection and respiratory compromise. Withdrawal of the causative drug, supportive care, and adjuvant therapy improve prognosis. Over the past decade, randomized controlled trials and meta-analyses have supported a role for cyclosporine, tumor necrosis factor alpha inhibitors, and combination therapy with intravenous immune globulin and corticosteroids. This review summarizes the medical management of TEN in adult patients.
摘要:
中毒性表皮坏死松解症(TEN)是一种免疫介导的,严重的皮肤药物不良反应,其特征是表皮脱离影响超过30%的体表面积。TEN的死亡率超过20%,通常是由感染和呼吸道损害引起的。撤回致病药物,支持性护理,和辅助治疗改善预后。在过去的十年里,随机对照试验和荟萃分析支持环孢素的作用,肿瘤坏死因子α抑制剂,以及静脉注射免疫球蛋白和皮质类固醇的联合治疗。本文综述了成人患者TEN的医疗管理。