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Maja Mockenhaupt - One of the best experts on this subject based on the ideXlab platform.

  • interleukin 15 is associated with severity and mortality in Stevens Johnson Syndrome toxic epidermal necrolysis
    Journal of Investigative Dermatology, 2017
    Co-Authors: Maja Mockenhaupt, Pierre Wolkenstein, Ariane Dunant, Sabine Le Gouvello, Chunbing Chen, Olivier Chosidow, L Valeyrieallanore, Teresa Bellon, Peggy Sekula
    Abstract:

    Early diagnosis and prognosis monitoring for Stevens-Johnson Syndrome/toxic epidermal necrolysis (TEN) still remain a challenge. This study aims to explore any cytokine/chemokine with prognostic potential in Stevens-Johnson Syndrome/TEN. Through screening a panel of 28 serological factors, IL-6, IL-8, IL-15, tumor necrosis factor-α, and granulysin were upregulated in patients with Stevens-Johnson Syndrome/TEN and selected for the further validation in total 155 patients with Stevens-Johnson Syndrome/TEN, including 77 from Taiwan and 78 from the Registry of Severe Cutaneous Adverse Reactions. Among these factors evaluated, the levels of IL-15 ( r  = 0.401; P r  = 0.223; P  = 0.026) were significantly correlated with the disease severity in 112 samples after excluding patients with insufficient data to calculate the score of TEN. In addition, IL-15 was also associated with mortality ( P  = 0.002; odds ratio, 1.09; 95% confidence interval, 1.03–1.14; P  = 0.001; adjusted odds ratio, 1.10; 95% confidence interval, 1.04–1.16). Consistent results were obtained after the exclusion of Taiwanese patients with sepsis to rule out possible confounders. Moreover, IL-15 was shown to enhance cytotoxicity of cultured natural killer cells and blister cells from patients with TEN. Our findings highlight a usefulness of IL-15 in prognosis monitoring and therapeutic intervention of this devastating condition.

  • the current understanding of Stevens Johnson Syndrome and toxic epidermal necrolysis
    Expert Review of Clinical Immunology, 2011
    Co-Authors: Maja Mockenhaupt
    Abstract:

    Stevens–Johnson Syndrome has long been considered to resemble erythema multiforme with mucosal involvement, but is now thought to form a single disease entity with toxic epidermal necrolysis. Although Stevens–Johnson Syndrome is less severe, etiology, genetic susceptibility and pathomechanism are the same for Stevens–Johnson Syndrome/toxic epidermal necrolysis. The condition is mainly caused by drugs, but also by infections and probably other risk factors not yet identified. Identification of the cause is important for the individual patient and in cases of drug-induced disease withdrawal of the inducing drug(s) has an impact on the patient’s prognosis. If an infectious cause is suspected, adequate anti-infective treatment is needed. Besides this, supportive management is crucial to improve the patient’s state, probably more than specific immunomodulating treatments. Despite all of the therapeutic efforts, mortality is high and increases with disease severity, patients’ age and underlying medical conditio...

  • medications as risk factors of Stevens Johnson Syndrome and toxic epidermal necrolysis in children a pooled analysis
    Pediatrics, 2009
    Co-Authors: Natacha Levi, Maja Mockenhaupt, Sylvie Bastujigarin, Jeanclaude Roujeau, Antoine Flahault, Judith P Kelly, Elvira Martin, David W Kaufman, Patrick Maison
    Abstract:

    OBJECTIVE. The aim of this study was to determine the relation of medications to the risk of Stevens-Johnson Syndrome and toxic epidermal necrolysis in children METHODS. We conducted a pooled analysis by using data from 2 multicenter international case-control studies: the severe cutaneous adverse reaction (SCAR) study and the multinational severe cutaneous adverse reaction (EuroSCAR) study conducted in France, Germany, Italy, Portugal, the Netherlands, Austria, and Israel. We selected case subjects aged RESULTS. Our study included 80 cases and 216 matched controls. Antiinfective sulfonamides, phenobarbital, carbamazepine, and lamotrigine were strongly associated with the risk of Stevens-Johnson Syndrome or toxic epidermal necrolysis. Significant associations were highlighted in univariate analysis for valproic acid and nonsteroidal antiinflammatory drugs as a group and for acetaminophen (paracetamol) in multivariate analysis. CONCLUSIONS. We confirmed 4 previously highly suspected drug risk factors for Stevens-Johnson Syndrome/toxic epidermal necrolysis in children: antiinfective sulfonamides, phenobarbital, carbamazepine, and lamotrigine. Among more unexpected risk factors, we suspect that acetaminophen (paracetamol) use increases the risk of Stevens-Johnson Syndrome or toxic epidermal necrolysis.

  • 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, 2002
    Co-Authors: Ariane Auquierdunant, Maja Mockenhaupt, Luigi Naldi, Osvaldo Correia, Werner Schroder, Jeanclaude Roujeau
    Abstract:

    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.

  • nevirapine and the risk of Stevens Johnson Syndrome or toxic epidermal necrolysis
    AIDS, 2001
    Co-Authors: Jeanpaul Fagot, Maja Mockenhaupt, Luigi Naldi, Jannico Bouwesbavinck, Cecile Viboud, Jeanclaude Roujeau
    Abstract:

    Background Toxic epidermal necrolysis and Stevens–Johnson Syndrome are rare, life-threatening, drug-induced cutaneous reactions. We conducted a case–control study to quantify the risks associated with the use of specific drugs. Methods Data were obtained through surveillance networks in France, Germany, Italy, and Portugal. Drug use before the onset of disease was compared in 245 people who were hospitalized because of toxic epidermal necrolysis or Stevens–Johnson Syndrome and 1147 patients hospitalized for other reasons (controls). Crude relative risks were calculated and adjusted for confounding by multivariate methods when numbers were large enough. Results Among drugs usually used for short periods, the risks were increased for trimethoprim–sulfamethoxazole and other sulfonamide antibiotics (crude relative risk, 172; 95 percent confidence interval, 75 to 396), chlormezanone (crude relative risk, 62; 21 to 188), aminopenicillins (multivariate relative risk, 6.7; 2.5 to 18), quinolones (multivariate rel...

Jeanclaude Roujeau - One of the best experts on this subject based on the ideXlab platform.

  • medications as risk factors of Stevens Johnson Syndrome and toxic epidermal necrolysis in children a pooled analysis
    Pediatrics, 2009
    Co-Authors: Natacha Levi, Maja Mockenhaupt, Sylvie Bastujigarin, Jeanclaude Roujeau, Antoine Flahault, Judith P Kelly, Elvira Martin, David W Kaufman, Patrick Maison
    Abstract:

    OBJECTIVE. The aim of this study was to determine the relation of medications to the risk of Stevens-Johnson Syndrome and toxic epidermal necrolysis in children METHODS. We conducted a pooled analysis by using data from 2 multicenter international case-control studies: the severe cutaneous adverse reaction (SCAR) study and the multinational severe cutaneous adverse reaction (EuroSCAR) study conducted in France, Germany, Italy, Portugal, the Netherlands, Austria, and Israel. We selected case subjects aged RESULTS. Our study included 80 cases and 216 matched controls. Antiinfective sulfonamides, phenobarbital, carbamazepine, and lamotrigine were strongly associated with the risk of Stevens-Johnson Syndrome or toxic epidermal necrolysis. Significant associations were highlighted in univariate analysis for valproic acid and nonsteroidal antiinflammatory drugs as a group and for acetaminophen (paracetamol) in multivariate analysis. CONCLUSIONS. We confirmed 4 previously highly suspected drug risk factors for Stevens-Johnson Syndrome/toxic epidermal necrolysis in children: antiinfective sulfonamides, phenobarbital, carbamazepine, and lamotrigine. Among more unexpected risk factors, we suspect that acetaminophen (paracetamol) use increases the risk of Stevens-Johnson Syndrome or toxic epidermal necrolysis.

  • 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, 2002
    Co-Authors: Ariane Auquierdunant, Maja Mockenhaupt, Luigi Naldi, Osvaldo Correia, Werner Schroder, Jeanclaude Roujeau
    Abstract:

    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.

  • nevirapine and the risk of Stevens Johnson Syndrome or toxic epidermal necrolysis
    AIDS, 2001
    Co-Authors: Jeanpaul Fagot, Maja Mockenhaupt, Luigi Naldi, Jannico Bouwesbavinck, Cecile Viboud, Jeanclaude Roujeau
    Abstract:

    Background Toxic epidermal necrolysis and Stevens–Johnson Syndrome are rare, life-threatening, drug-induced cutaneous reactions. We conducted a case–control study to quantify the risks associated with the use of specific drugs. Methods Data were obtained through surveillance networks in France, Germany, Italy, and Portugal. Drug use before the onset of disease was compared in 245 people who were hospitalized because of toxic epidermal necrolysis or Stevens–Johnson Syndrome and 1147 patients hospitalized for other reasons (controls). Crude relative risks were calculated and adjusted for confounding by multivariate methods when numbers were large enough. Results Among drugs usually used for short periods, the risks were increased for trimethoprim–sulfamethoxazole and other sulfonamide antibiotics (crude relative risk, 172; 95 percent confidence interval, 75 to 396), chlormezanone (crude relative risk, 62; 21 to 188), aminopenicillins (multivariate relative risk, 6.7; 2.5 to 18), quinolones (multivariate rel...

Stephen C Foster - One of the best experts on this subject based on the ideXlab platform.

  • Stevens Johnson Syndrome and toxic epidermal necrolysis a review of the literature
    Annals of Allergy Asthma & Immunology, 2005
    Co-Authors: Erik Letko, Dean N Papaliodis, George N Papaliodis, Yassine J Daoud, Razzaque A Ahmed, Stephen C Foster
    Abstract:

    Objective To perform a comprehensive review of Stevens-Johnson Syndrome and toxic epidermal necrolysis. Data Sources A MEDLINE search was performed for the years 1975 to 2003 using the keywords Stevens-Johnson Syndrome and toxic epidermal necrolysis to identify relevant articles published in English in peer-reviewed journals. Study Selection All clinical studies that reported on 4 or more patients, review articles, and experimental studies that concerned disease mechanisms were selected and further analyzed. Clinical reports that included fewer than 4 patients were selected only if they were believed to carry a significant message about disease mechanism or therapy. Results Stevens-Johnson Syndrome and toxic epidermal necrolysis seem to be variants of the same disease with differing severities. A widely accepted consensus regarding diagnostic criteria and therapy does not exist at present. Despite the recent experimental studies, the pathogenic mechanisms of these diseases remain unknown. Although progress in survival through early hospitalization in specialized burn units has been made, the prevalence of life-long disability from the ocular morbidity of Stevens-Johnson Syndrome and toxic epidermal necrolysis has remained unchanged for the past 35 years. Further progress depends on modification of the acute phase of the disease rather than continuation of supportive care. The available published evidence indicates that a principal problem in the pathogenesis is immunologic and that immunomodulatory intervention with short-term, high-dose intravenous steroids or intravenous immunoglobulin holds the most promise for effective change in survival and long-term morbidity. Conclusions The results of this review call for a widely accepted consensus on diagnostic criteria for Stevens-Johnson and toxic epidermal necrolysis and multicenter collaboration in experimental studies and clinical trials that investigate disease mechanisms and novel therapeutic interventions, respectively.

Luigi Naldi - One of the best experts on this subject based on the ideXlab platform.

  • 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, 2002
    Co-Authors: Ariane Auquierdunant, Maja Mockenhaupt, Luigi Naldi, Osvaldo Correia, Werner Schroder, Jeanclaude Roujeau
    Abstract:

    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.

  • nevirapine and the risk of Stevens Johnson Syndrome or toxic epidermal necrolysis
    AIDS, 2001
    Co-Authors: Jeanpaul Fagot, Maja Mockenhaupt, Luigi Naldi, Jannico Bouwesbavinck, Cecile Viboud, Jeanclaude Roujeau
    Abstract:

    Background Toxic epidermal necrolysis and Stevens–Johnson Syndrome are rare, life-threatening, drug-induced cutaneous reactions. We conducted a case–control study to quantify the risks associated with the use of specific drugs. Methods Data were obtained through surveillance networks in France, Germany, Italy, and Portugal. Drug use before the onset of disease was compared in 245 people who were hospitalized because of toxic epidermal necrolysis or Stevens–Johnson Syndrome and 1147 patients hospitalized for other reasons (controls). Crude relative risks were calculated and adjusted for confounding by multivariate methods when numbers were large enough. Results Among drugs usually used for short periods, the risks were increased for trimethoprim–sulfamethoxazole and other sulfonamide antibiotics (crude relative risk, 172; 95 percent confidence interval, 75 to 396), chlormezanone (crude relative risk, 62; 21 to 188), aminopenicillins (multivariate relative risk, 6.7; 2.5 to 18), quinolones (multivariate rel...

Lars E French - One of the best experts on this subject based on the ideXlab platform.