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Toxic epidermal necrolysis - management issues and treatment options.
MedLine Citation:
PMID:  22928157     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Toxic epidermal necrolysis (TEN) and Steven-Johnson syndrome (SJS) are characterized by extensive necrosis and cleavage of the epidermis from the dermis akin to a superficial or partial thickness burn. Sepsis is the usual cause of mortality but much of the pathophysiologic process results from an outpouring of cytokines and matrixmetalloproteinases (MMPs) which have a destructive effect on the extracellular matrix and may play a part in the epidermal/dermal cleavage seen with this disease. Recent attention has been focused on the modulation of proteases in an attempt to decrease the MMP-mediated destruction. Nanocrystalline silver (NCS) is one such agent that has good anti-microbial efficacy, but is also effective in modulating MMP levels. Twelve cases of confirmed TEN that were treated with NCS were analyzed with a view to assessing efficacy and setting logical guidelines for managing this condition, particularly in relation to immunosupressed patients. From this study important issues have been highlighted for discussion.
Authors:
Alan D Widgerow
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Publication Detail:
Type:  Journal Article     Date:  2011-09-03
Journal Detail:
Title:  International journal of burns and trauma     Volume:  1     ISSN:  2160-2026     ISO Abbreviation:  Int J Burns Trauma     Publication Date:  2011  
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-08-30     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101581623     Medline TA:  Int J Burns Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-50     Citation Subset:  -    
Affiliation:
FACS Emeritus Professor Plastic Surgery University of the Witwatersrand, Johannesburg South Africa and Adar Science Inc. Irvine California USA.
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