Document Detail


Dexamethasone pulse therapy for Stevens-Johnson syndrome/toxic epidermal necrolysis.
MedLine Citation:
PMID:  17340021     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mortality in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is high. Apart from intensive supportive therapy, no generally accepted specific treatment regimen exists. The role of corticosteroids in SJS/TEN is controversial. It is possible that high-dose pulse therapy with corticosteroids might be an improvement on long-term lower dose therapy, by combining higher efficacy with a diminished risk both of infection and of delayed wound healing. The aim of this study was to evaluate the efficacy of dexamethasone pulse therapy with respect to mortality and healing time of patients with SJS/TEN. A small, uncontrolled series of consecutive inpatients with SJS/TEN was treated with dexamethasone pulse therapy. The efficacy of this treatment was assessed retrospectively using SCORTEN. Twelve patients were included over a period of 10 years. One patient died, while SCORTEN predicted a fatal outcome of 4 patients. Stabilization was reached after 2.3 days on average, total re-epithelialization after 13.9 days. The results of this study bear no statistical relevance due to the small number of patients. In conclusion, short-term dexamethasone pulse therapy, given at an early stage of the disease, may contribute to a reduced mortality rate in SJS/TEN without increasing healing time. A larger controlled trial is warranted to investigate further the use of dexamethasone pulse therapy in SJS/TEN.
Authors:
Sylvia H Kardaun; Marcel F Jonkman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta dermato-venereologica     Volume:  87     ISSN:  0001-5555     ISO Abbreviation:  Acta Derm. Venereol.     Publication Date:  2007  
Date Detail:
Created Date:  2007-03-06     Completed Date:  2007-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370310     Medline TA:  Acta Derm Venereol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  144-8     Citation Subset:  IM    
Affiliation:
Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. s.h.kardaun@derm.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Dexamethasone / administration & dosage*
Epidermal Necrolysis, Toxic / drug therapy*
Female
Humans
Male
Middle Aged
Pulse Therapy, Drug
Retrospective Studies
Stevens-Johnson Syndrome / drug therapy*
Chemical
Reg. No./Substance:
50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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