Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit

Detalhes bibliográficos
Autor(a) principal: Pinheiro, Susana
Data de Publicação: 2013
Outros Autores: Carvalho, Ricardo, Ramos, Sara, Diogo, Carla, Caetano, Marisa, Cabral, Luís, Cruzeiro, Celso
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150
Resumo: Introduction: Toxic Epidermal Necrolysis is a drug-induced life-threatening systemic disease, characterized by extensive dermoepidermal detachment and mucositis. At least 95% of cases are believed to be drug-induced. SCORTEN is a scoring system used to stratify severity and predict mortality. Treatment demands immediate withdrawal of the causative drug and early transfer to a burn centre for specific and intensive care.Material and Methods: Authors have performed a retrospective study of 21 consecutive patients with SJS/ Toxic Epidermal Necrolysis admitted in the Burn Centre of Coimbra’s University Hospital, between January 1999 and December 2010, and have compared the actual mortality rate with that predicted by SCORTEN, in order to assess the predictive capacity of SCORTEN. Analysis of results andtreatment options were conducted. Data were analysed in SPSS 17.0®.Results: Thirteen females (61.9%) and 8 males (38.1%) were treated, mean age 55.6 ± 23.7 years and with a mean of 51% ± 22.4% epidermal detachment. The overall observed mortality rate was 47.6% and the one predicted by SCORTEN 42.2%. Immediate withdrawal of the causative drug and early transfer of the patient to our burn centre were the basis of treatment.Conclusion: Toxic Epidermal Necrolysis pathophysiology remains to be clarified and no specific treatment has unequivocally proven to be effective. SCORTEN seems to be an accurate scoring system for estimation of mortality rate.
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spelling Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn UnitNecrólise Epidérmica Tóxica: A Experiência da Unidade de Queimados de CoimbraIntroduction: Toxic Epidermal Necrolysis is a drug-induced life-threatening systemic disease, characterized by extensive dermoepidermal detachment and mucositis. At least 95% of cases are believed to be drug-induced. SCORTEN is a scoring system used to stratify severity and predict mortality. Treatment demands immediate withdrawal of the causative drug and early transfer to a burn centre for specific and intensive care.Material and Methods: Authors have performed a retrospective study of 21 consecutive patients with SJS/ Toxic Epidermal Necrolysis admitted in the Burn Centre of Coimbra’s University Hospital, between January 1999 and December 2010, and have compared the actual mortality rate with that predicted by SCORTEN, in order to assess the predictive capacity of SCORTEN. Analysis of results andtreatment options were conducted. Data were analysed in SPSS 17.0®.Results: Thirteen females (61.9%) and 8 males (38.1%) were treated, mean age 55.6 ± 23.7 years and with a mean of 51% ± 22.4% epidermal detachment. The overall observed mortality rate was 47.6% and the one predicted by SCORTEN 42.2%. Immediate withdrawal of the causative drug and early transfer of the patient to our burn centre were the basis of treatment.Conclusion: Toxic Epidermal Necrolysis pathophysiology remains to be clarified and no specific treatment has unequivocally proven to be effective. SCORTEN seems to be an accurate scoring system for estimation of mortality rate.Introdução: A necrólise epidérmica tóxica é uma doença sistémica grave, potencialmente fatal, caracterizada por febre, descolamento dermoepidérmico extenso e erosão das mucosas. Em 95% dos casos, consiste numa reacção idiossincrática à administração de fármacos. A gravidade da doença é estratificada através da aplicação de uma escala de previsão da mortalidade, denominada SCORTEN. O tratamento obriga à suspensão imediata do fármaco suspeito e à referenciação do doente a uma Unidade de Queimados capaz de assegurar um tratamento específico.Material e Métodos: Estudo retrospectivo de 21 doentes internados com SJS/ Necrólise Epidérmica Tóxica na Unidade de Queimados dos Hospitais da Universidade de Coimbra, entre Janeiro de 1999 e Dezembro de 2010 com avaliação dos resultados e das opções terapêuticas. Comparação das taxas de mortalidade desses doentes com as previstas pelo SCORTEN, no sentido de avaliar a capacidade preditiva desta escala. Os dados foram analisados no programa SPSS 17.0®.Resultados: Foram internados 13 doentes do sexo feminino (61,9%) e 8 do sexo masculino (38,1%), com média de idades de 55,6 ± 23,7 anos e com 51% ± 22,4% de superfície corporal atingida. A taxa de mortalidade dos doentes internados foi de 47,6% e a prevista pelo SCORTEN foi de 42,2%. %. O tratamento instituído centrou-se na remoção imediata do fármaco suspeito e na referenciação precoce do doente para a unidade.Conclusão: A fisiopatologia da necrólise epidérmica tóxica não está completamente esclarecida, pelo que não existe actualmente uma terapêutica específica, comprovadamente eficaz. A utilização do SCORTEN permite uma previsão adequada da taxa de mortalidade nestes doentes.Ordem dos Médicos2013-08-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegapplication/mswordhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150oai:ojs.www.actamedicaportuguesa.com:article/150Acta Médica Portuguesa; Vol. 26 No. 4 (2013): July-August; 341-348Acta Médica Portuguesa; Vol. 26 N.º 4 (2013): Julho-Agosto; 341-3481646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150/3695https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150/6867https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150/6868https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/150/6869Pinheiro, SusanaCarvalho, RicardoRamos, SaraDiogo, CarlaCaetano, MarisaCabral, LuísCruzeiro, Celsoinfo:eu-repo/semantics/openAccess2022-12-20T10:55:51Zoai:ojs.www.actamedicaportuguesa.com:article/150Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:22.865870Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
Necrólise Epidérmica Tóxica: A Experiência da Unidade de Queimados de Coimbra
title Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
spellingShingle Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
Pinheiro, Susana
title_short Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
title_full Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
title_fullStr Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
title_full_unstemmed Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
title_sort Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit
author Pinheiro, Susana
author_facet Pinheiro, Susana
Carvalho, Ricardo
Ramos, Sara
Diogo, Carla
Caetano, Marisa
Cabral, Luís
Cruzeiro, Celso
author_role author
author2 Carvalho, Ricardo
Ramos, Sara
Diogo, Carla
Caetano, Marisa
Cabral, Luís
Cruzeiro, Celso
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Pinheiro, Susana
Carvalho, Ricardo
Ramos, Sara
Diogo, Carla
Caetano, Marisa
Cabral, Luís
Cruzeiro, Celso
description Introduction: Toxic Epidermal Necrolysis is a drug-induced life-threatening systemic disease, characterized by extensive dermoepidermal detachment and mucositis. At least 95% of cases are believed to be drug-induced. SCORTEN is a scoring system used to stratify severity and predict mortality. Treatment demands immediate withdrawal of the causative drug and early transfer to a burn centre for specific and intensive care.Material and Methods: Authors have performed a retrospective study of 21 consecutive patients with SJS/ Toxic Epidermal Necrolysis admitted in the Burn Centre of Coimbra’s University Hospital, between January 1999 and December 2010, and have compared the actual mortality rate with that predicted by SCORTEN, in order to assess the predictive capacity of SCORTEN. Analysis of results andtreatment options were conducted. Data were analysed in SPSS 17.0®.Results: Thirteen females (61.9%) and 8 males (38.1%) were treated, mean age 55.6 ± 23.7 years and with a mean of 51% ± 22.4% epidermal detachment. The overall observed mortality rate was 47.6% and the one predicted by SCORTEN 42.2%. Immediate withdrawal of the causative drug and early transfer of the patient to our burn centre were the basis of treatment.Conclusion: Toxic Epidermal Necrolysis pathophysiology remains to be clarified and no specific treatment has unequivocally proven to be effective. SCORTEN seems to be an accurate scoring system for estimation of mortality rate.
publishDate 2013
dc.date.none.fl_str_mv 2013-08-30
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 26 No. 4 (2013): July-August; 341-348
Acta Médica Portuguesa; Vol. 26 N.º 4 (2013): Julho-Agosto; 341-348
1646-0758
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