Muñoz GF, Orta GFJ

Language: Spanish
References: 11
Page: 116-120
PDF size: 716.98 Kb.

ABSTRACT

Stevens Johnson Syndrome/toxic epidermal necrolysis is a rare acute condition with high morbidity and mortality. The incidence is estimated at 1 to 1.4 cases per million inhabitants per year. Despite its low frequency, the importance of these reactions because they can cause serious consequences or even lead to death. Mortality is estimated between 5 and 40%. Dermatitis is usually widespread and dominates the face, neck, trunk and limbs (may include the entire body, including palms and soles). The percentage of skin surface affected is forecast and it dermatoses classified into three groups: a) Stevens Johnson, when it affects less than 10% body surface. b) Overlap Stevens-Johnson syndrome / toxic epidermal necrolysis 10 to 30%. c) necrolysis toxic epidermal skin detachment greater than 30%. It has been shown that early referral before the seven days at a burn center reduces the incidence of bacteremia and sepsis mortality reduction to 4%. By contrast, mortality rises to 83% in patients referred after the seventh day. The theoretical basis on which to support the use of antiapoptotic drugs suggest the use of corticosteroids, immunosuppressant’s, plasmapheresis, drugs modulating effects of cytokines and immunoglobulins. However, the use of corticosteroids is not recommended, in our case the patient was operated on admission with high doses of steroids, showing no adverse effects or deterioration in its evolution. The long-term squeal include skin changes, mucosal, eye and lung, it is important to integrate the Department of Ophthalmology in patient care, as ocular squeal have an impact, social, psychological and economic value.

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