| Title: | Toxic epidermal necrolysis : lessons from three fatal cases |
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| Authors: | ID Demenj, Marko (Author)
ID Reljić, Vesna (Author)
ID Manojlović Gačić, Emilija (Author)
ID Vilotijević, Maja (Author)
ID Živanović, Dubravka (Author) |
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| Files: |  URL - Source URL, visit https://acta-apa.mf.uni-lj.si/journals/acta-dermatovenerol-apa/papers/10.15570/actaapa.2025.27/actaapa.2025.27.pdf
 PDF - Presentation file, download (54,82 MB)
MD5: 583043085A73871E17ED330C3BDA3FFA
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| Language: | English |
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| Typology: | 1.03 - Other scientific articles |
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| Organization: |  ZSD - Association of Slovenian Dermatovenereologists
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| Abstract: | Introduction: Toxic epidermal necrolysis (TEN) is a severe cutaneous adverse reaction triggered by various classes of drugs. Clinical manifestations include prodromal symptoms resembling a febrile illness, followed by skin and mucosal lesions. This study presents a series of fatal TEN cases, with a focus on factors that may have influenced mortality, including differential diagnoses, associated comorbidities, treatment choices, and complications of TEN. Methods: Data were collected from electronic medical records of patients hospitalized at a dermatology clinic. Results: Case 1 involved TEN in a 42-year-old female, initially misdiagnosed as mycoplasma-induced rash and mucositis (MIRM), who succumbed to sepsis. Case 2, a 50-year-old female with 80% of her body surface area affected, saw low-dose IVIg treatment prove ineffective, leading to multiorgan failure. Case 3 involved allopurinol-induced TEN in a 53-year-old with Balkan endemic nephropathy, resulting in fatal renal failure. Conclusions: The cases presented highlight potential challenges in differentiating TEN from MIRM in the early stages of TEN. Highdose IVIg is generally recommended, whereas the effectiveness of low-dose IVIg is inconsistent, and it proved insufficient in the case presented, potentially due to the presence of multiple comorbidities. Preexisting conditions such as renal disease significantly influence fatal outcomes in TEN patients. |
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| Keywords: | Balkan endemic nephropathy, cutaneous adverse reactions, low-dose IVIG, mycoplasma-induced rash and mucositis, toxic epidermal necrolysis |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Submitted for review: | 06.06.2025 |
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| Article acceptance date: | 20.08.2025 |
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| Publication date: | 01.09.2025 |
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| Place of publishing: | Ljubljana |
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| Publisher: | Združenje slovenskih dermatovenerologov |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 139-144 |
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| Numbering: | Vol. 34, issue 3 |
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| PID: | 20.500.12556/DiRROS-29908  |
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| UDC: | 616.5:579 |
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| ISSN on article: | 1318-4458 |
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| DOI: | 10.15570/actaapa.2025.27 |
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| COBISS.SI-ID: | 260312835 |
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| Copyright: | Na spletni strani revije navedeno: Acta Dermatovenerologica Alpina, Pannonica et Adriatica (ISSN 1318-4458) is an open access medical journal published quarterly by the Association of Slovenian Dermatovenerologists (https://acta-apa.mf.uni-lj.si/index.php); Authors publishing in our journal retain copyright of their work under the Creative Commons Attribution License (CC BY 4.0). This license allows unrestricted use, distribution, and reproduction of the work in any medium, provided the original author(s) and copyright holder(s) are appropriately credited, and the original publication in the journal is properly cited, following established academic practices (https://acta-apa.mf.uni-lj.si/submissions.php). |
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| Publication date in DiRROS: | 15.06.2026 |
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| Views: | 206 |
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| Downloads: | 162 |
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