The Most Recent Information Regarding the Management of Stevens - Johnson syndrome And Toxic Epidermal Necrolysis.
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Abstract
The dermatological conditions known as Stevens - Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening conditions that are characterized by extensive epidermal necrolysis and sloughing. The incidence rates differ from one location to another, with the United Kingdom experiencing an annual incidence of 5.76 cases per million people between the years 1995 and 2013. In terms of mortality rates, females are more likely to be affected than males, with mortality rates ranging from 4.8-9% to 14.8-48%.
Providing patients with SJS or TEN with nonpharmacologic treatment consists of providing supportive care, managing fluid and electrolyte levels, controlling infections, and treating wounds. The identification and the elimination of the substance that is responsible for the condition is the most important component. Patients with SJS or TEN have lower fluid requirements than burn patients, so it is essential that they receive proper management of their fluid, electrolyte, and nutritional needs.
Antibiotics used as a preventative measure do not improve outcomes; however, infection prevention requires proper wound care and the use of antiseptic handling. The decision to pursue surgical debridement as a treatment option is contingent on the location of care where the patient is being treated. The role of surgical debridement has been the subject of debate. It has been demonstrated that anti-shear therapy, which entails the aspiration of blister fluid and the preservation of denuded epidermis, is effective in lowering mortality rates.
Because SJS/TEN is such a rare disease, there have been very few prospective studies conducted on the subject of pharmacologic treatment for the condition. There have been a number of different treatment regimens that have been reported, including corticosteroids, IVIg, cyclosporine, and TNF-alpha inhibitors; however, it is difficult to determine whether the remission of the disease was due to a particular treatment or whether it was the natural course of the disease.
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