title: Cyclosporine for SJS/TEN: a case series and review of the literature.
abstract: Clear guidelines for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are lacking due to its infrequency and the absence of large controlled studies. Systemic corticosteroids and intravenous immunoglobulin (IVIG) have received considerable attention, though reports of the use of these agents have demonstrated mixed success rates in improving morbidity and mortality from SJS/TEN. We present a case series of 4 patients with SJS/TEN who rapidly responded to treatment with cyclosporin A (CsA). We discuss the proposed mechanism of action and the rationale for the use of cyclosporin based on the currently understood pathophysiologic mechanism of TEN.
authors.affiliation: Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, Texas, USA. drew.reese@amedd.army.mil
authors.forename: Drew
authors.initials: D
authors.lastname: Reese
authors.forename: J Scott
authors.initials: JS
authors.lastname: Henning
authors.forename: Kyle
authors.initials: K
authors.lastname: Rockers
authors.forename: Denise
authors.initials: D
authors.lastname: Ladd
authors.forename: Robert
authors.initials: R
authors.lastname: Gilson
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D016572:Cyclosporine / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced / Q000188:drug therapy*; D013419:Sulfamethizole / Q000009:adverse effects; D014227:Triazines / Q000009:adverse effects; D014295:Trimethoprim / Q000009:adverse effects; D000096926:Benzenesulfonamides
chemical_list: D000082:Acetaminophen; D018712:Analgesics, Non-Narcotic; D000890:Anti-Infective Agents; D000927:Anticonvulsants; D016572:Cyclosporine; D003879:Dermatologic Agents; D004338:Drug Combinations; D000077213:Lamotrigine; D013419:Sulfamethizole; D014227:Triazines; D014295:Trimethoprim; C029078:trimethoprim sulfamethizole; D000096926:Benzenesulfonamides