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Comment on: Proposal for a new diagnostic classification of photodistributed Stevens-Johnson syndrome and toxic epidermal necrolysis.
Thwala, Bukiwe N; Teixeira, Nadine; Zitha, Eddy; Mpungose, Aneliswa; Isaacs, Thuraya; Peter, Jonathan G; Lehloenya, Rannakoe J.
Afiliación
  • Thwala BN; Division of Allergy and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
  • Teixeira N; Combined Drug Allergy Clinic and Groote Schuur Hospital, Cape Town, South Africa.
  • Zitha E; Division of Allergy and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
  • Mpungose A; Combined Drug Allergy Clinic and Groote Schuur Hospital, Cape Town, South Africa.
  • Isaacs T; Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
  • Peter JG; Division of Allergy and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
  • Lehloenya RJ; Combined Drug Allergy Clinic and Groote Schuur Hospital, Cape Town, South Africa.
Eur J Med Res ; 29(1): 83, 2024 Jan 29.
Article en En | MEDLINE | ID: mdl-38287381
ABSTRACT
Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap (SJS/TEN), collectively referred to SJS/TEN, form a spectrum of severe life-threatening adverse drug reactions whose pathomechanism is not fully understood. The article "Photodistributed Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis A Systematic Review and Proposal for a New Diagnostic Classification" by McKinley et. al., discusses a distinct distribution of epidermal necrosis in SJS/TEN, attributable to preceding exposure to ultraviolet radiation (UVR), and relative sparing of photo-protected areas. After reviewing numerous cases within the Immune-mediated Adverse drug Reactions in African HIV endemic setting Register and Biorepository (IMARI-SA) at the University of Cape Town with a similar clinical pattern as those published by McKinley et. al., we propose that the relative sparing of some areas giving an impression of photo-distribution is due to localised increase in skin pressure that reduces the blood supply in that area below a critical threshold. A dip in blood supply below this critical threshold quantitively limited T lymphocytes and cytokines that drive SJS/TEN to reach and damage the skin.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Stevens-Johnson Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Revista: Eur J Med Res Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Stevens-Johnson Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Revista: Eur J Med Res Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Reino Unido