Plasmapheresis: an effective treatment in patients of toxic epidermal necrolysis: case report of two patients
Keywords:
Toxic epidermal necrolysis (TEN), plasmapheresis, SCORTEN ScoreAbstract
Toxic epidermal necrolysis (TEN) is an acute, life-threatening cutaneous drug reaction that predominantly involves the skin and mucous membranes. It is a rare disorder and treated as a medical emergency, due to its fatal outcome. The principles of management include immediate removal of culprit drug(s), supportive management and specific drug therapies or procedures, of which plasmapheresis is one treatment modality. We report two patients of TEN, being successfully treated with plasmapheresis, proving it to be a life saving treatment modality.ÂReferences
French LE, Princ C. Erythema multiforme, Steven-Johnson syndrome and toxic epidermal necrolysis. In: Bolognia JL, Jorizzo JL, Schaffer J, editors. Bolognia Dermatology. Vol 1, 3rd edn. Philadelphia: Elsevier Saunders; 2012. P. 319-33.
Gardezi S, Kazmi A, Aman S, Nadeem M, Khan MS, Sohail M. A clinicoetiological study of Stevens-Johnson syndrome and toxic epidermal necrolysis. J Pak Assoc Dermatol. 2013;23:5-13.
Endorf F, Cancio L, Gibran N. Toxic Epidermal Necrolysis Clinical Guidelines. J Burn Care Res. 2008;29:706-12.
Yamada H, Takamori K. Status of plasmapheresis for the treatment of toxic epidermal necrolysis in Japan. Ther Apher Dial. 2008;12:335-59.
Narita YM, Hirahara K, Mizukawa Y, Kano Y, Shiohara T. Efficacy of plasmapheresis for the treatment of severe toxic epidermal necrolysis: Is cytokine expression analysis useful in predicting its therapeutic efficacy? J Dermatol. 2011;38:236-45.
Mahale R, Chetan G, Sagar H, Aggarwal R. Plasmapheresis as an adjuvant treatment modality in toxic epidermal necrolysis: A case report. J Clin Diagn Res. 2011;5:107-8.
Szczeklik W, Nowak I, Seczynska B, Sega A, Krolikowski W, Musial J. Beneficial therapeutic effect of plasmapheresis after unsuccessful treatment with corticosteroids in two patients with severe toxic epidermal necrolysis. Ther Apher Dial. 2010;14:354-7.
Kostal M, Blaha M, Lanska M, Kostalova M, Blaha V, Stepanova E et al. Beneficial effect of plasma exchange in the treatment of toxic epidermal necrolysis: A series of four cases. J Clin Apher. 2012;27:215-20.
Yamada H, Takamori K, Yaguchi H, Ogawa H. A Study of the efficacy of plasmapheresis for the treatment of drug induced toxic epidermal necrolysis. Ther Apher. 1998;2:153-6.
Bamichas G, Natse T, Christidou F, Stangou M, Karagianni A, Koukourikos S et al. Plasma exchange in patients with toxic epidermal necrolysis. Ther Apher. 2002;6:225-8.
Posadinu MA, Sanna E, Canu V, Ciccarese M, Pala PG, Cossu M. Lyell's syndrome: proposal for a therapeutic protocol. G Ital Nefrol. 2012; 29 (Suppl 54):147-8.
Chaidemenos G, Chrysomallis F, Sombolos K, Mourellou O, Ioannides D, Papakonstantinou M. Plasmapheresis in toxic epidermal necrolysis. Int J Dermatol. 1997;36:218-2.
