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Toxic Epidermal Necrolysis (Lyell's Syndrome)

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An exfoliative disease of skin seen primarily in adults and characterized by flaccid bullae and spreading erythema so that the skin has the appearance of being scalded. It results primarily from a toxic reaction to various drugs, but occasionally occurs as a result of infection, neoplastic conditions, or other exposure.

Also Known As:

Lyell's Syndrome; Epidermal Necrolysis, Toxic; Nonstaphylococcal Scalded Skin Syndrome; Epidermal Necrolyses, Toxic; Lyell Syndrome; Lyells Syndrome; Necrolyses, Toxic Epidermal; Necrolysis, Toxic Epidermal; Syndrome, Lyell's; Toxic Epidermal Necrolyses; Scalded Skin Syndrome, Nonstaphylococcal

Networked: 1143 relevant articles (34 outcomes, 54 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Stevens-Johnson Syndrome
2.	Graft vs Host Disease (Graft-Versus-Host Disease)
3.	Burns
4.	Skin Diseases
5.	Urticaria (Hives)

Experts

1.	Chung, Wen-Hung: 15 articles (09/2015 - 03/2005)
2.	Hung, Shuen-Iu: 15 articles (09/2015 - 03/2005)
3.	Aihara, Michiko: 11 articles (10/2015 - 10/2007)
4.	Roujeau, Jean-Claude: 11 articles (06/2011 - 01/2002)
5.	Sotozono, Chie: 10 articles (10/2015 - 02/2007)
6.	Kinoshita, Shigeru: 10 articles (10/2015 - 02/2007)
7.	Kaniwa, Nahoko: 10 articles (10/2015 - 11/2008)
8.	Ueta, Mayumi: 9 articles (10/2015 - 02/2007)
9.	Saito, Yoshiro: 9 articles (10/2015 - 11/2008)
10.	Chen, Yuan-Tsong: 9 articles (09/2013 - 03/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Toxic Epidermal Necrolysis:

1.	Immunoglobulins (Immunoglobulin)IBA 05/01/2012 - "Controlled studies are needed to confirm the efficacy of intravenous immunoglobulin in Stevens-Johnson's syndrome / toxic epidermal necrolysis, but the results seem promising." 11/01/2012 - "Toxic epidermal necrolysis: performance of SCORTEN and the score-based comparison of the efficacy of corticosteroid therapy and intravenous immunoglobulin combined therapy in China." 08/01/2012 - "The efficacy of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis: a systematic review and meta-analysis." 08/01/2005 - "His toxic epidermal necrolysis responded well to 3 days of intravenous immunoglobulin. " 08/01/2005 - "High-dose intravenous immunoglobulin in the treatment of toxic epidermal necrolysis: a study of ocular benefits."
2.	Intravenous Immunoglobulins (IVIG)FDA Link 02/01/2000 - "[Response to the comment on the contribution "Successful therapy of Lyell syndrome with intravenous immunoglobulins"]." 11/01/2005 - "Efficacy of low dose intravenous immunoglobulins in children with toxic epidermal necrolysis: an open uncontrolled study." 01/01/2002 - "International multi-centre studies are needed in the form of randomised controlled trials, to evaluate treatments for toxic epidermal necrolysis, especially those using high doses of steroid and intravenous immunoglobulins." 03/01/2010 - "The authors report the experience with low dose IVIG (0.1 g/kg/day for four consecutive days for treating a 3 years old boy with toxic epidermal necrolysis with favourable outcome without early complications." 02/01/2007 - "IVIG for the treatment of toxic epidermal necrolysis."
3.	Adrenal Cortex Hormones (Corticosteroids)IBA 11/01/1986 - "Improved burn center survival of patients with toxic epidermal necrolysis managed without corticosteroids." 05/01/2010 - "After immediately discontinuing the drug suspected of being responsible for toxic epidermal necrolysis, we treated with systemic corticosteroids in an initial dose of up to 1.5 mg/kg. Moreover, special emphasis was put on basic measures such as control of vital parameters. " 01/01/2009 - "The use of systemic corticosteroids in the treatment of toxic epidermal necrolysis has always been controversial, some consider corticosteroids life-saving while others believe that they increase mortality. " 09/01/2008 - "Corticosteroids in toxic epidermal necrolysis." 07/01/2003 - "Treatment included suspension of the offending drug and then, except for the cases with toxic epidermal necrolysis, administration of corticosteroids. "
4.	AntibodiesIBA 05/01/1994 - "We studied the immunopathologic characteristics of five cases of toxic epidermal necrolysis by using a large panel of antibodies. " 07/18/1981 - "Drug-dependent binding of circulating antibodies in drug-induced toxic epidermal necrolysis." 05/01/2006 - "Human intravenous immunoglobulins (IVIg) which contain anti-CD95 antibodies have been proposed to treat toxic epidermal necrolysis (TEN). " 11/04/2000 - "Specific blockade of Fas, for example with intravenous immunoglobulin preparations containing specific anti-Fas antibodies, has shown great promise in the treatment of toxic epidermal necrolysis and may also be useful in the treatment of acute graft-versus-host disease. " 08/01/2000 - "Specific blockade of Fas, for example with intravenous immunoglobulin preparations that contain specific anti-Fas antibodies, has shown great promise in the treatment of toxic epidermal necrolysis and may also be useful in the treatment acute graft versus host disease. "
5.	Cyclophosphamide (Cytoxan)FDA LinkGeneric 03/01/1993 - "Efficacy of cyclophosphamide in toxic epidermal necrolysis." 11/01/1991 - "Efficacy of cyclophosphamide in toxic epidermal necrolysis. " 06/01/2014 - "Cyclophosphamide-induced toxic epidermal necrolysis: vigilance needed." 10/01/1996 - "Cyclophosphamide in the treatment of toxic epidermal necrolysis."
6.	Anticonvulsants (Antiepileptic Drugs)IBA 01/01/2013 - "Toxic epidermal necrolysis associated with antiepileptic drugs and cranial radiation therapy." 03/01/2007 - "Toxic epidermal necrolysis (TEN) is a severe mucocutaneous syndrome that can be occasionally caused by anticonvulsant drugs. " 01/01/2007 - "Severe cutaneous adverse effects such as SJS and toxic epidermal necrolysis can arise during treatment with antiepileptic drugs (AEDs). " 02/01/2004 - "Toxic epidermal necrolysis in patients receiving anticonvulsants and cranial irradiation: a risk to consider." 01/01/2015 - "To assess the association between Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) and antiepileptics including the most recently authorized drugs. "
7.	Phenytoin (Dilantin)FDA LinkGeneric 11/01/2014 - "Phenytoin induced toxic epidermal necrolysis." 01/01/2012 - "Phenytoin-induced Lyell's syndrome." 04/01/2007 - "Phenytoin-induced toxic epidermal necrolysis in a neurosurgical patient." 03/01/1996 - "We present a case of phenytoin-induced toxic epidermal necrolysis resulting in 60-70% skin involvement. " 03/01/1996 - "Phenytoin-induced toxic epidermal necrolysis: a case report."
8.	lamotrigine (Lamictal)FDA LinkGeneric 10/01/2014 - "It is generally well-tolerated, but recent pharmacoepidemiological evidence suggests that lamotrigine is associated with risks of developing severe cutaneous drug reactions like toxic epidermal necrolysis (TEN). " 10/01/2014 - "Lamotrigine-induced toxic epidermal necrolysis confirmed by in vitro granulysin and cytokine assays." 09/30/2014 - "We report the case of a young woman who developed toxic epidermal necrolysis, possibly resulting from lamotrigine therapy. " 03/01/2014 - "Toxic epidermal necrolysis induced by lamotrigine treatment in a child." 03/01/2014 - "Lamotrigine-associated with toxic epidermal necrolysis: a case report and Chinese literature review."
9.	Anti-Bacterial Agents (Antibiotics)IBA 11/01/2002 - "A series of antibiotics may be responsible for toxic epidermal necrolysis. " 04/01/2001 - "We present the case of a patient treated with antibiotics who developed an exantema-like eruption, diagnosed as Lyell syndrome. " 01/01/1975 - "[Lyell's syndrome developed as a result of treatment with antibiotics]." 06/01/1973 - "[Case of Lyell's syndrome induced by antibiotics]." 11/01/2014 - "The authors conducted a retrospective chart review of patients with extensive toxic epidermal necrolysis between January 2001 and December 2012 admitted to the Victorian Adult Burns Service, Melbourne, Australia, with respect to the amount of positive cultures, number and type of organisms identified, whether empirical antibiotics had been commenced, and whether antibiotics were effective against organisms cultured. "
10.	Carboxymethylcellulose Sodium (Polycell)FDA Link 05/01/2011 - "A useful combination in the treatment of toxic epidermal necrolysis: Octenoidine dihydrocholoride solution and Aquacel-Ag." 02/01/2008 - "AQUACEL Ag in the treatment of toxic epidermal necrolysis (TEN)." 02/01/2010 - "Aquacel Ag with Vaseline gauze in the management of toxic epidermal necrolysis (TEN)." 05/01/2014 - "Clinical evaluation comparing the efficacy of aquacel Ag with vaseline gauze versus 1% silver sulfadiazine cream in toxic epidermal necrolysis." 05/01/2014 - "The purpose of this study was to determine whether using Aquacel Ag (ConvaTec, Skillman, New Jersey) with Vaseline (Unilever, London, England) gauze instead of silver sulfadiazine cream (SSD) as the wound care protocol to treat toxic epidermal necrolysis (TEN) can improve wound healing, pain control, and reduction of labor costs. "

Therapies and Procedures

1.	Plasmapheresis 03/01/2011 - "Efficacy of plasmapheresis for the treatment of severe toxic epidermal necrolysis: Is cytokine expression analysis useful in predicting its therapeutic efficacy?" 10/01/2008 - "This study describes the efficacy of plasmapheresis for the treatment of toxic epidermal necrolysis (TEN), as reported in Japan. " 05/01/1998 - "A study of the efficacy of plasmapheresis for the treatment of drug induced toxic epidermal necrolysis." 01/01/2012 - "Although plasmapheresis is expensive and requires easy venous access, it could be included in the first-line treatment of toxic epidermal necrolysis. " 05/01/1998 - "The efficacy of plasmapheresis for the treatment of toxic epidermal necrolysis (TEN) in our patient and related reports in the literature were examined. "
2.	Plasma Exchange 12/01/1985 - "Since there is no effective treatment for toxic epidermal necrolysis, a controlled clinical trial to evaluate the effectiveness of plasma exchange would seem worthwhile." 12/01/1985 - "Five patients with severe drug-induced toxic epidermal necrolysis improved rapidly after one to two plasma exchanges. " 01/01/2012 - "Beneficial effect of plasma exchange in the treatment of toxic epidermal necrolysis: a series of four cases." 06/01/2002 - "We describe our experience with plasma exchange (PE) therapy in 13 patients with drug-induced toxic epidermal necrolysis (TEN), 4 of whom had malignant disorders. " 06/01/2002 - "Plasma exchange in patients with toxic epidermal necrolysis."
3.	Radiotherapy 03/01/2015 - "Toxic epidermal necrolysis in polymedicated patient treated with radiotherapy." 05/01/2010 - "Radiotherapy: a protective role for toxic epidermal necrolysis?" 03/01/2007 - "Brain radiotherapy during treatment with anticonvulsant therapy as a trigger for toxic epidermal necrolysis." 01/01/2008 - "Generalized eruptions associated with radiotherapy such as erythema multiforme (EM), Steven-Johnson syndrome and toxic epidermal necrolysis are uncommon reactions. " 10/01/2014 - "Erythema multiforme (EM), Stevens Johnson syndrome (SJS), and toxic epidermal necrolysis syndrome (TENS) are exfoliative disorders that may present as complications in some patients undergoing radiotherapy. "
4.	Transplantation (Transplant Recipients) 01/01/2006 - "To report successful management of acute stage toxic epidermal necrolysis (TEN) by amniotic membrane transplantation. " 09/01/2014 - "To evaluate ocular features and histopathologic changes in patients with toxic epidermal necrolysis (TEN) treated with amniotic membrane transplantation (AMT) in the acute phase. " 09/01/2014 - "Amniotic membrane transplantation in acute toxic epidermal necrolysis: histopathologic changes and ocular surface features after 1-year follow-up." 10/01/2012 - "Toxic epidermal necrolysis in a 15-month-old girl successfully treated with amniotic membrane transplantation." 03/01/2010 - "Efficacy and limitation of sutureless amniotic membrane transplantation for acute toxic epidermal necrolysis."
5.	Hemoperfusion 01/01/1987 - "[A case of effective treatment of Lyell's syndrome using hemosorption]." 01/01/1988 - "[Use of hemosorption in a 10-month-old infant with Lyell's syndrome]." 06/01/1985 - "[Use of hemosorption in the complex treatment of patients with Lyell's syndrome]." 11/01/1993 - "[Effectiveness of hemosorption in intensive care of patients with Lyell's syndrome]." 01/01/2014 - "Beneficial therapeutic effects of hemoperfusion in the treatment of severe Stevens-Johnson syndrome/toxic epidermal necrolysis: preliminary results."