Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit

Authors

  • Susana Pinheiro Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Ricardo Carvalho Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Sara Ramos Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Carla Diogo Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Marisa Caetano Serviços Farmacêuticos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Luís Cabral Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Celso Cruzeiro Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

DOI:

https://doi.org/10.20344/amp.150

Abstract

Introduction: Toxic Epidermal Necrolysis is a drug-induced life-threatening systemic disease, characterized by extensive dermoepidermal detachment and mucositis. At least 95% of cases are believed to be drug-induced. SCORTEN is a scoring system used to stratify severity and predict mortality. Treatment demands immediate withdrawal of the causative drug and early transfer to a burn centre for specific and intensive care.
Material and Methods: Authors have performed a retrospective study of 21 consecutive patients with SJS/ Toxic Epidermal Necrolysis admitted in the Burn Centre of Coimbra’s University Hospital, between January 1999 and December 2010, and have compared the actual mortality rate with that predicted by SCORTEN, in order to assess the predictive capacity of SCORTEN. Analysis of results and
treatment options were conducted. Data were analysed in SPSS 17.0®.
Results: Thirteen females (61.9%) and 8 males (38.1%) were treated, mean age 55.6 ± 23.7 years and with a mean of 51% ± 22.4% epidermal detachment. The overall observed mortality rate was 47.6% and the one predicted by SCORTEN 42.2%. Immediate withdrawal of the causative drug and early transfer of the patient to our burn centre were the basis of treatment.
Conclusion: Toxic Epidermal Necrolysis pathophysiology remains to be clarified and no specific treatment has unequivocally proven to be effective. SCORTEN seems to be an accurate scoring system for estimation of mortality rate.

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Author Biographies

Susana Pinheiro, Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Interna do 6º ano do Internato Médico de Cirurgia Plástica, Reconstrutiva e Estética no Centro Hospitalar e Universitário de Coimbra

Assistente convidada de Anatomia I e II da Faculdade de Medicina da Universidade de Coimbra

Ricardo Carvalho, Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Sara Ramos, Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Carla Diogo, Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Marisa Caetano, Serviços Farmacêuticos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Luís Cabral, Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Celso Cruzeiro, Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

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Published

2013-08-30

How to Cite

1.
Pinheiro S, Carvalho R, Ramos S, Diogo C, Caetano M, Cabral L, Cruzeiro C. Toxic Epidermal Necrolysis: The Experience of Coimbra’s Burn Unit. Acta Med Port [Internet]. 2013 Aug. 30 [cited 2024 Mar. 29];26(4):341-8. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/150