Document Detail


Toxic epidermal necrolysis in pregnancy: case report and review of the literature.
MedLine Citation:
PMID:  20671561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors report the case of a 29-year-old pregnant woman (2g1p) in the 16th week of gestation presenting with extensive toxic epidermal necrolysis (TEN). The cutaneous symptoms began at hands, feet, and in the mouth and developed during the course of 10 days to cover 75% of her TBSA, whereas total epidermolysis was present on more than 40% of her TBSA. Because of progressive swelling and bleeding of the oral mucosa, tracheal intubation was necessary to secure the airway of the patient. Critical care management required sedation, tracheotomy and artificial ventilation (14 days), prolonged fluid resuscitation, daily wound care, topical antiseptic and systemic antibiotic medication, hemostatic therapy and blood transfusion, hypercaloric nutrition, and frequent obstetric ultrasound evaluations. Reepithelialization began simultaneously with progressive epidermolysis and was completed after 35 days of conservative treatment. Because the patient experienced a swollen vulva and a stenotic birth channel, typical sequelae of TEN, a primary cesarean section was required after 40 weeks of gestation. The male infant showed neither signs of skin detachment nor sequelae caused by the prolonged therapy for the mother. A multidisciplinary approach and appropriate medical infrastructure are required to solve the challenge of TEN in pregnancy. In addition, the particular role of gestation in the pathophysiology of TEN needs to be explored further.
Authors:
Manuel F Struck; Till Illert; Yvonne Liss; Ina D Bosbach; Beate Reichelt; Michael Steen
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of burn care & research : official publication of the American Burn Association     Volume:  31     ISSN:  1559-0488     ISO Abbreviation:  J Burn Care Res     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-09-09     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  816-21     Citation Subset:  IM    
Affiliation:
Department of Plastic and Hand Surgery, Burn Trauma Center, Bergmannstrost Hospital, Halle/Saale, Germany. manuelstruck@web.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section
Epidermal Necrolysis, Toxic / therapy*
Female
Humans
Pregnancy
Pregnancy Complications / therapy*
Pregnancy Outcome

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