RF - Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Treatment Update.

作者：A. de Quintana-Sancho, M. Rubio-Lombraña, O. Guergue Díaz-de-Cerio, A. Barrutia-Borque · 发表于：Actas Dermo-Sifiliográficas · 年份：2016 · DOI：10.1016/j.ad.2015.05.003 · 研究领域：Medicine

Please cite this article as: de Quintana-Sancho A, RubioLombraña M, Díaz-de-Cerio OG, Barrutia-Borque A. FR Síndrome de Stevens-Johnson y necrólisis epidérmica tóxica. Actualización en el manejo terapéutico. Actas Dermosifiliogr. 2016;107:247--248. ∗ Corresponding author. E-mail address: adriandeq@gmail.com (A. de Quintana-Sancho). Since then, cases have been published of treatment with cyclophosphamide, systemic corticosteroids, plasmapheresis, cyclosporin, intravenous immunoglobulins (IVIGs), and tumor necrosis factor inhibitors (anti-TNF agents). In this summary, we wish to comment on the findings of 2 recently published studies on the management of this disease. In 1998, IVIG was reported as an effective therapy in patients with SJS/TEN for the first time. Since then, the studies published show conflicting results, and it has not been possible to demonstrate a significant improvement in survival among patients treated with IVIG compared to those who receive only supportive care. However, a study has shown decreased mortality when IVIG is used at high doses (≥ 2 g/kg). Kirchhof et al. conducted a retrospective study and analyzed the outcomes of treatment with IVIG 1 g/kg/d for 3 days or cyclosporin 3-5 mg/kg/d for up to a maximum of 7 days. Of the 64 patients with clinical and histologic evidence of SJS/TEN included in the study, 12 received conservative treatment, 35 received IVIG, 15 received cyclosporin, and 2 received both IVIG and cyclosporin. Based on the estimated m...