title: Etanercept therapy for toxic epidermal necrolysis.
abstract: BACKGROUND
  Toxic epidermal necrolysis (TEN) is a severe and potentially lethal drug reaction for which no standard treatment is available.
  
  
  OBJECTIVE
  To describe a case series of patients with TEN treated with a single dose of etanercept.
  
  
  METHODS
  We observed 10 consecutive patients with TEN. For each patient, we recorded the presence of comorbidities and all the drugs recently started (ie, in the last month). In all cases, 50 mg of etanercept was administered in a single subcutaneous injection. The clinical severity of disease was computed using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Using the probabilities of death linked to each level of SCORTEN score, we calculated the expected probability of death in our patients. Healing was defined as complete reepithelialization, and a time to healing curve was then obtained using the Kaplan-Meier method.
  
  
  RESULTS
  All patients promptly responded to treatment, reaching complete reepithelialization without complications or side effects. The median time to healing was 8.5 days.
  
  
  CONCLUSIONS
  This is a small, uncontrolled case series.
  
  
  CONCLUSIONS
  These preliminary results suggest the possibility that tumor necrosis factor-alfa may be an effective target for control of TEN, a dangerous skin condition for which no effective cure has yet been found.
authors.affiliation: Health Services Research Unit, IDI-IRCCS, Rome, Italy. Electronic address: aparad@tin.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Paradisi
authors.affiliation: Health Services Research Unit, IDI-IRCCS, Rome, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Abeni
authors.affiliation: I Division of Dermatology, IDI-IRCCS, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Bergamo
authors.affiliation: Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricci
authors.affiliation: Department of Dermatology, "La Sapienza" University, Rome, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Didona
authors.affiliation: I Division of Dermatology, IDI-IRCCS, Rome, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Didona
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D062326:Re-Epithelialization; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept
keywords: adverse drug reaction; etanercept; therapy; toxic epidermal necrolysis