The Experts below are selected from a list of 2211 Experts worldwide ranked by ideXlab platform
Jean-claude Roujeau - One of the best experts on this subject based on the ideXlab platform.
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correlations between clinical patterns and causes of Erythema Multiforme majus stevens johnson syndrome and toxic epidermal necrolysis results of an international prospective study
Archives of Dermatology, 2002Co-Authors: Ariane Auquierdunant, Maja Mockenhaupt, Luigi Naldi, Osvaldo Correia, Werner Schroder, Jean-claude RoujeauAbstract:Background It was proposed that Stevens-Johnson syndrome and toxic epidermal necrolysis differed from Erythema Multiforme majus by the pattern and localization of skin lesions. Objective To evaluate the validity of this clinical separation. Design Case-control study. Settings Active survey from 1989 to 1995 of 1800 hospital departments in Europe. Patients A total of 552 patients and 1720 control subjects. Methods Cases were sorted into 5 groups (Erythema Multiforme majus, Stevens-Johnson syndrome, Stevens-Johnson syndrome–toxic epidermal necrolysis overlap, toxic epidermal necrolysis, and unclassified Erythema Multiforme majus or Stevens-Johnson syndrome) by experts blinded as to exposure to drugs and other factors. Etiologic fractions for herpes and drugs obtained from case-control analyses were compared between these groups. Results Erythema Multiforme majus significantly differed from Stevens-Johnson syndrome, overlap, and toxic epidermal necrolysis by occurrence in younger males, frequent recurrences, less fever, milder mucosal lesions, and lack of association with collagen vascular diseases, human immunodeficiency virus infection, or cancer. Recent or recurrent herpes was the principal risk factor for Erythema Multiforme majus (etiologic fractions of 29% and 17%, respectively) and had a role in Stevens-Johnson syndrome (etiologic fractions of 6% and 10%) but not in overlap cases or toxic epidermal necrolysis. Drugs had higher etiologic fractions for Stevens-Johnson syndrome, overlap, or toxic epidermal necrolysis (64%-66%) than for Erythema Multiforme majus (18%). Unclassified cases mostly behaved clinically like Erythema Multiforme. Conclusions This large prospective study confirmed that Erythema Multiforme majus differs from Stevens-Johnson syndrome and toxic epidermal necrolysis not only in severity but also in several demographic characteristics and causes.
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stevens johnson syndrome and toxic epidermal necrolysis are severity variants of the same disease which differs from Erythema Multiforme
Journal of Dermatology, 1997Co-Authors: Jean-claude RoujeauAbstract:A new classification, based on the pattern and distribution of cutaneous lesions, separates Erythema Multiforme major from Stevens-Johnson syndrome. A retrospective re-classification of 76 cases supported the validity of that separation by demonstrating differing causes and pathology. Another prospective international case-control study found differing demographic characteristics and risk factors between Erythema Multiforme major on the one hand and Stevens-Johnson syndrome or toxic epidermal necrolysis on the other. Erythema Multiforme major was mainly related to Herpes virus infection, while Stevens-Johnson syndrome and toxic epidermal necrolysis were associated with drug reactions.
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clinical classification of cases of toxic epidermal necrolysis stevens johnson syndrome and Erythema Multiforme
Archives of Dermatology, 1993Co-Authors: Sylvie Bastujigarin, Neil H Shear, Berthold Rzany, Robert S. Stern, Luigi Naldi, Jean-claude RoujeauAbstract:• Background and Design.— To conduct a prospective case-control study about causative factors of severe bullous Erythema Multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis, we needed to define criteria for classifying the cases and standardize the collection of data so that cases could be reliably diagnosed according to this classification. Based on review of case histories and photographs of patients, a group of experts proposed a classification based on the pattern of Erythema Multiforme—like lesions (categorized as typical targets, raised or flat atypical targets, and purpuric macules) and on the extent of epidermal detachment. An atlas illustrating this classification that included photographs and schematic drawings was developed. We compared the evaluations of 28 cases by four nonphysicians relying on the atlas with the evaluations of the same cases by five experts not using the atlas to determine the usefulness of this atlas for classifying cases according to our nosologic schema. Results.— The following consensus classification in five categories was proposed: bullous Erythema Multiforme , detachment below 10% of the body surface area plus localized "typical targets" or "raised atypical targets"; Stevens-Johnson syndrome , detachment below 10% of the body surface area plus widespread Erythematous or purpuric macules or flat atypical targets; overlap Stevens-Johnson syndrome— toxic epidermal necrolysis , detachment between 10% and 30% of the body surface area plus widespread purpuric macules or flat atypical targets; toxic epidermal necrolysis with spots , detachment above 30% of the body surface area plus widespread purpuric macules or flat atypical targets; and toxic epidermal necrolysis without spots , detachment above 10% of the body surface area with large epidermal sheets and without any purpuric macule or target. Using the atlas, the nonexperts showed excellent agreement with the experts. Conclusion.— This study suggests that an illustrated atlas is a useful tool for standardizing the diagnosis of acute severe bullous disorders that are attibuted to drugs or infectious agents. Whether the five categories proposed represent distinct etiopathologic entities will require further epidemiologic and laboratory investigations. ( Arch Dermatol. 1993;129:92-96)
Robert J Conklin - One of the best experts on this subject based on the ideXlab platform.
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Erythema Multiforme a review and contrast from stevens johnson syndrome toxic epidermal necrolysis
Dental Clinics of North America, 2005Co-Authors: Michele P Williams, Robert J ConklinAbstract:Erythema Multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis are separate diseases. Recent evidence suggests that they have different etiologies and require different treatments. This article provides an overview of the two conditions with emphasis on the differences between them. An outline of the diagnosis and management of the diseases is included.
Neil H Shear - One of the best experts on this subject based on the ideXlab platform.
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Erythema Multiforme stevens johnson syndrome and toxic epidermal necrolysis in children a review of 10 years experience
Drug Safety, 2002Co-Authors: Rachel Forman, Gideon Koren, Neil H ShearAbstract:Objective: To review 10 years’ experience in a tertiary care paediatric hospital of Erythema Multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). In addition, to apply a recently described classification system for EM, SJS and TEN in children.
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clinical classification of cases of toxic epidermal necrolysis stevens johnson syndrome and Erythema Multiforme
Archives of Dermatology, 1993Co-Authors: Sylvie Bastujigarin, Neil H Shear, Berthold Rzany, Robert S. Stern, Luigi Naldi, Jean-claude RoujeauAbstract:• Background and Design.— To conduct a prospective case-control study about causative factors of severe bullous Erythema Multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis, we needed to define criteria for classifying the cases and standardize the collection of data so that cases could be reliably diagnosed according to this classification. Based on review of case histories and photographs of patients, a group of experts proposed a classification based on the pattern of Erythema Multiforme—like lesions (categorized as typical targets, raised or flat atypical targets, and purpuric macules) and on the extent of epidermal detachment. An atlas illustrating this classification that included photographs and schematic drawings was developed. We compared the evaluations of 28 cases by four nonphysicians relying on the atlas with the evaluations of the same cases by five experts not using the atlas to determine the usefulness of this atlas for classifying cases according to our nosologic schema. Results.— The following consensus classification in five categories was proposed: bullous Erythema Multiforme , detachment below 10% of the body surface area plus localized "typical targets" or "raised atypical targets"; Stevens-Johnson syndrome , detachment below 10% of the body surface area plus widespread Erythematous or purpuric macules or flat atypical targets; overlap Stevens-Johnson syndrome— toxic epidermal necrolysis , detachment between 10% and 30% of the body surface area plus widespread purpuric macules or flat atypical targets; toxic epidermal necrolysis with spots , detachment above 30% of the body surface area plus widespread purpuric macules or flat atypical targets; and toxic epidermal necrolysis without spots , detachment above 10% of the body surface area with large epidermal sheets and without any purpuric macule or target. Using the atlas, the nonexperts showed excellent agreement with the experts. Conclusion.— This study suggests that an illustrated atlas is a useful tool for standardizing the diagnosis of acute severe bullous disorders that are attibuted to drugs or infectious agents. Whether the five categories proposed represent distinct etiopathologic entities will require further epidemiologic and laboratory investigations. ( Arch Dermatol. 1993;129:92-96)
Michele P Williams - One of the best experts on this subject based on the ideXlab platform.
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Erythema Multiforme a review of epidemiology pathogenesis clinical features and treatment
Dental Clinics of North America, 2013Co-Authors: Firoozeh Samim, Ajit Auluck, Christopher Zed, Michele P WilliamsAbstract:Abstract Erythema Multiforme (EM) is an acute, immune-mediated disorder affecting the skin and/or mucous membranes, including the oral cavity. Target or iris lesions distributed symmetrically on the extremities and trunk characterize the condition. Infections are the most common cause of EM and the most frequently implicated infectious agent causing clinical disease is the herpes simplex virus. The diagnosis of EM is typically based on the patient's history and clinical findings. Management involves controlling the underlying infection or causative agent, symptom control, and adequate hydration. The epidemiology, pathogenesis, clinical features, diagnosis, and treatment of EM are reviewed in this article.
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Erythema Multiforme a review and contrast from stevens johnson syndrome toxic epidermal necrolysis
Dental Clinics of North America, 2005Co-Authors: Michele P Williams, Robert J ConklinAbstract:Erythema Multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis are separate diseases. Recent evidence suggests that they have different etiologies and require different treatments. This article provides an overview of the two conditions with emphasis on the differences between them. An outline of the diagnosis and management of the diseases is included.
Luigi Naldi - One of the best experts on this subject based on the ideXlab platform.
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correlations between clinical patterns and causes of Erythema Multiforme majus stevens johnson syndrome and toxic epidermal necrolysis results of an international prospective study
Archives of Dermatology, 2002Co-Authors: Ariane Auquierdunant, Maja Mockenhaupt, Luigi Naldi, Osvaldo Correia, Werner Schroder, Jean-claude RoujeauAbstract:Background It was proposed that Stevens-Johnson syndrome and toxic epidermal necrolysis differed from Erythema Multiforme majus by the pattern and localization of skin lesions. Objective To evaluate the validity of this clinical separation. Design Case-control study. Settings Active survey from 1989 to 1995 of 1800 hospital departments in Europe. Patients A total of 552 patients and 1720 control subjects. Methods Cases were sorted into 5 groups (Erythema Multiforme majus, Stevens-Johnson syndrome, Stevens-Johnson syndrome–toxic epidermal necrolysis overlap, toxic epidermal necrolysis, and unclassified Erythema Multiforme majus or Stevens-Johnson syndrome) by experts blinded as to exposure to drugs and other factors. Etiologic fractions for herpes and drugs obtained from case-control analyses were compared between these groups. Results Erythema Multiforme majus significantly differed from Stevens-Johnson syndrome, overlap, and toxic epidermal necrolysis by occurrence in younger males, frequent recurrences, less fever, milder mucosal lesions, and lack of association with collagen vascular diseases, human immunodeficiency virus infection, or cancer. Recent or recurrent herpes was the principal risk factor for Erythema Multiforme majus (etiologic fractions of 29% and 17%, respectively) and had a role in Stevens-Johnson syndrome (etiologic fractions of 6% and 10%) but not in overlap cases or toxic epidermal necrolysis. Drugs had higher etiologic fractions for Stevens-Johnson syndrome, overlap, or toxic epidermal necrolysis (64%-66%) than for Erythema Multiforme majus (18%). Unclassified cases mostly behaved clinically like Erythema Multiforme. Conclusions This large prospective study confirmed that Erythema Multiforme majus differs from Stevens-Johnson syndrome and toxic epidermal necrolysis not only in severity but also in several demographic characteristics and causes.
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clinical classification of cases of toxic epidermal necrolysis stevens johnson syndrome and Erythema Multiforme
Archives of Dermatology, 1993Co-Authors: Sylvie Bastujigarin, Neil H Shear, Berthold Rzany, Robert S. Stern, Luigi Naldi, Jean-claude RoujeauAbstract:• Background and Design.— To conduct a prospective case-control study about causative factors of severe bullous Erythema Multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis, we needed to define criteria for classifying the cases and standardize the collection of data so that cases could be reliably diagnosed according to this classification. Based on review of case histories and photographs of patients, a group of experts proposed a classification based on the pattern of Erythema Multiforme—like lesions (categorized as typical targets, raised or flat atypical targets, and purpuric macules) and on the extent of epidermal detachment. An atlas illustrating this classification that included photographs and schematic drawings was developed. We compared the evaluations of 28 cases by four nonphysicians relying on the atlas with the evaluations of the same cases by five experts not using the atlas to determine the usefulness of this atlas for classifying cases according to our nosologic schema. Results.— The following consensus classification in five categories was proposed: bullous Erythema Multiforme , detachment below 10% of the body surface area plus localized "typical targets" or "raised atypical targets"; Stevens-Johnson syndrome , detachment below 10% of the body surface area plus widespread Erythematous or purpuric macules or flat atypical targets; overlap Stevens-Johnson syndrome— toxic epidermal necrolysis , detachment between 10% and 30% of the body surface area plus widespread purpuric macules or flat atypical targets; toxic epidermal necrolysis with spots , detachment above 30% of the body surface area plus widespread purpuric macules or flat atypical targets; and toxic epidermal necrolysis without spots , detachment above 10% of the body surface area with large epidermal sheets and without any purpuric macule or target. Using the atlas, the nonexperts showed excellent agreement with the experts. Conclusion.— This study suggests that an illustrated atlas is a useful tool for standardizing the diagnosis of acute severe bullous disorders that are attibuted to drugs or infectious agents. Whether the five categories proposed represent distinct etiopathologic entities will require further epidemiologic and laboratory investigations. ( Arch Dermatol. 1993;129:92-96)