Document Detail


Successful dexamethasone pulse therapy in a toxic epidermal necrolysis (TEN) patient featuring recurrent TEN to oxazepam.
MedLine Citation:
PMID:  11722448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 62-year-old female patient is described who developed toxic epidermal necrolysis (TEN) after medication with phenytoin and oxazepam. Initially phenytoin was discontinued and dexamethasone pulse therapy (1.5 mg/kg on 3 consecutive days) was initiated on the tenth day of skin disease. This resulted in clinical improvement. Histologically re-epithelialization could be demonstrated below the necrotic epidermis. However, on the eighteenth day of skin disease (10 days after discontinuation of phenytoin and 8 days after the start of dexamethasone pulse therapy), a histologically verified rebound-TEN developed with a detachment of 95%. Oxazepam was stopped and a second series of dexamethasone pulse therapy was given. Re-epithelialization began within 24 h of the start of the second series of dexamethasone pulse therapy, and continued to almost complete recovery within 1 week.
Authors:
J B van der Meer; M L Schuttelaar; G G Toth; S H Kardaun; G Beerthuizen; M C de Jong; M F Jonkman; P Nieuwenhuis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical and experimental dermatology     Volume:  26     ISSN:  0307-6938     ISO Abbreviation:  Clin. Exp. Dermatol.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-27     Completed Date:  2002-01-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7606847     Medline TA:  Clin Exp Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  654-6     Citation Subset:  IM    
Affiliation:
Department of Dermatology (Centre of Blistering Skin Diseases), Faculty of Medical Sciences, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, the Netherlands. secreteriaat@derm.azg.nl
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / therapeutic use
Brain Neoplasms / drug therapy,  secondary
Dexamethasone / administration & dosage*
Drug Therapy, Combination
Epidermal Necrolysis, Toxic / drug therapy*,  etiology*,  pathology
Epidermis / drug effects,  pathology
Female
Glucocorticoids / administration & dosage*
Humans
Hypnotics and Sedatives / adverse effects*
Lung Neoplasms / drug therapy
Middle Aged
Oxazepam / adverse effects*
Phenytoin / therapeutic use
Pulse Therapy, Drug
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Glucocorticoids; 0/Hypnotics and Sedatives; 50-02-2/Dexamethasone; 57-41-0/Phenytoin; 604-75-1/Oxazepam

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