title: Progression of toxic epidermal necrolysis after tanning bed exposure.
abstract: BACKGROUND
  In addition to recreational tanning bed use, UV radiation exposures are sometimes sought to self-treat skin conditions. The ability of tanning bed radiation exposure to trigger toxic epidermal necrolysis has not been reported.
  
  
  METHODS
  A young woman attempted to treat a self-limiting drug hypersensitivity reaction via tanning bed radiation exposure, which resulted in a systemic toxic epidermal necrolysis-like reaction. Studies with cultured keratinocytes and an epithelial cell line reveal that UV-A radiation can synergize with other stimuli such as phorbol esters or interleukin 1 to produce large amounts of tumor necrosis factor, providing a potential mechanism for this exaggerated reaction.
  
  
  CONCLUSIONS
  In addition to inducing photodamage and skin cancer, tanning bed radiation exposure can trigger a toxic epidermal necrolysis-like reaction, possibly via the exaggerated production of keratinocyte cytokines such as tumor necrosis factor.
authors.affiliation: Department of Dermatology, Indiana University School of Medicine, 550 N University Blvd, Indianapolis, IN 46202, USA.
authors.forename: Na Tosha
authors.initials: NT
authors.lastname: Gatson
authors.forename: Jared B
authors.initials: JB
authors.lastname: Travers
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Hassani
authors.forename: Simon J P
authors.initials: SJ
authors.lastname: Warren
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Hyatt
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Travers
mesh_terms: D002460:Cell Line; D018450:Disease Progression; D004890:Erythema / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D015603:Keratinocytes / Q000378:metabolism / Q000528:radiation effects; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D055108:Sunbathing; D016896:Treatment Outcome; D048069:Tumor Necrosis Factors / Q000096:biosynthesis; D014466:Ultraviolet Rays / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous; D048069:Tumor Necrosis Factors; D007052:Ibuprofen