1/4. stevens-johnson syndrome caused by the antiretroviral drug nevirapine.nevirapine is a non-nucleoside reverse transcriptase inhibitor widely used in combination with other antiretroviral agents for the treatment of hiv infection. Severe rash, including the stevens-johnson syndrome (SJS), is the major toxicity of nevirapine and is described in the package labeling with a prominent, boxed warning. Though physicians treating large populations of patients with hiv are well aware of this complication, only one other report of nevirapine-associated SJS has been documented in the dermatology literature. We describe 2 cases of SJS related to nevirapine use and review the literature on this newly recognized association.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. stevens-johnson syndrome associated with Malarone antimalarial prophylaxis.To the best of our knowledge, stevens-johnson syndrome (SJS) has not been reported previously as an adverse reaction to Malarone, which is a combination of atovaquone and proguanil hydrochloride used for antimalarial prophylaxis and therapy. We describe a 65-year-old patient who had SJS with typical clinical and histopathological findings associated with the use of Malarone prophylaxis for malaria. This report should alert physicians to this severe cutaneous reaction, and Malarone should be added to the list of drugs that can potentially cause SJS.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. stevens-johnson syndrome (SJS): effectiveness of corticosteroids in management and recurrent SJS.To confirm that corticosteroids are beneficial in the treatment of stevens-johnson syndrome (SJS), 15 patients with the syndrome were evaluated by the same group of physicians over 2 years. All patients had cutaneous and most had mucosal lesions. patients were treated with corticosteroids ranging from prednisone 40 mg daily to methylprednisolone 750 mg daily. The same group of physicians participated in the management of these patients until recovery. No deaths occurred among the 15 patients. Recovery was complete in all cases, and there was no residual skin, mucosal, or visceral damage except for minimal scarring in one patient. In some cases, reversal of disease after onset of corticosteroid therapy was sufficiently dramatic to demonstrate a benefit. The use of corticosteroids in the treatment of SJS remains controversial. We conclude that corticosteroids are beneficial in treatment of the syndrome. They may be lifesaving in some patients and should be the standard of therapy. SJS should be considered to be erythema multiforme with either bullous lesions or visceral involvement or both.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/4. erythema multiforme and stevens-johnson syndrome. Descriptive and therapeutic controversy.diagnosis and particularly the management of erythema multiforme and stevens-johnson syndrome are controversial in medical textbooks and thus in individual cases. In these diseases, fatalities may result from various causes, including secondary infection or visceral organ damage to lung, liver, or kidneys. We present a series of 13 cases managed by one group of physicians which demonstrates the controversy in certain cases, and we review the controversy in the medical literature. Corticosteroid therapy used in this series was considered beneficial in every case by the managing physician and lifesaving in some cases. There were no fatalities in this series. Although the summation may be considered as our opinion only, the frequently suggested "controlled trial of corticosteroid therapy" can probably never be done for ethical reasons, and series such as this will have to establish the standard of therapy.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |