title: A study of the efficacy of plasmapheresis for the treatment of drug induced toxic epidermal necrolysis.
abstract: The efficacy of plasmapheresis for the treatment of toxic epidermal necrolysis (TEN) in our patient and related reports in the literature were examined. The patient, a 41-year-old female, was diagnosed as having drug (Sedes-G [isopropylantipyrin, arylisopropylacetoureid, and phenacetinum]) induced TEN. Upon admission to our hospital, extensive corticostroid therapy was initiated. After 6 days, because more than 90% of the patient's body surface was affected by TEN, it was concluded that the patient was unresponsive to corticosteroid therapy. Double filtration plasmapheresis (DFPP) was therefore begun. After 2 sessions of DFPP, extensive reepithelialization rapidly occurred, and after 3 sessions of DFPP, the improvement was dramatic. The patient's condition had almost healed during 1 month's hospitalization. It has been reported in the literature that 22 patients with drug induced TEN have been treated with plasmapheresis. The mortality rate of 23 patients, including our patient, was 17.4%. The rate of effectiveness of plasmapheresis on drug induced TEN is 82.6%. It appears that some kind of necrolytic factors were removed by the plasmapheresis. This suggests that plasmapheresis may be an effective treatment for drug induced TEN.
authors.affiliation: Department of Dermatology, International Goodwill Hospital, Yokohama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Takamori
authors.forename: H
authors.initials: H
authors.lastname: Yaguchi
authors.forename: H
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D004338:Drug Combinations; D005260:Female; D006801:Humans; D010956:Plasmapheresis / Q000379:methods; D013262:Stevens-Johnson Syndrome / Q000209:etiology / Q000628:therapy*
chemical_list: D004338:Drug Combinations