[Fatal toxic respiratory epitheliolysis. Subacute tracheo-bronchial desquamation in Stevens-Johnson syndrome].
Acute bronchial mucosal sloughing related to Toxic Epidermal Necrolysis (Lyell syndrome) is widely reported in literature. On the contrary severe respiratory involvement is rare in post-infectious or toxic Epitheliolysis (Stevens-Johnson syndrome). There is no well-known predictive sign of bronchial epithelium involvement. An 18-year-old patient was admitted for Stevens-Johnson syndrome related to sulfasalazine (salazosulfapyridine). There were no respiratory signs. An acute respiratory failure occurred 36 hours after from admission due to an obstructive and desquamative necrosis of the tracheobronchial epithelium. We purpose that a fiberoptic laryngoscopy should be performed even in non-dyspneic patients suffering from Stevens-Johnson syndrome if hypersecretion is present. Fiberoptic bronchoscopy can be helpful in these cases.
Martin
L
L
Service de Dermatologie, CHU Trousseau, Chambray les Tours, France.
Hazouard
E
E
Michalak-Provost
S
S
Maurage
C
C
Machet
L
L
D000208:Acute Disease; D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001344:Autopsy; D001982:Bronchial Diseases / Q000139:chemically induced* / Q000473:pathology*; D001999:Bronchoscopy; D017809:Fatal Outcome; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy; D007828:Laryngoscopy; D008297:Male; D011237:Predictive Value of Tests; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000473:pathology; D020545:Respiratory Mucosa / Q000187:drug effects* / Q000473:pathology*; D013262:Stevens-Johnson Syndrome / Q000209:etiology* / Q000473:pathology*; D012460:Sulfasalazine / Q000009:adverse effects*; D013997:Time Factors; D014133:Tracheal Diseases / Q000139:chemically induced* / Q000473:pathology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; D012460:Sulfasalazine