Academic literature on the topic 'Toxic Epidermal Necrolysis Amoxicillin Adverse Drug Reactions'
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Journal articles on the topic "Toxic Epidermal Necrolysis Amoxicillin Adverse Drug Reactions"
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Narasimha G., Lakshmi, and Kalpana P. "Amoxicillin induced toxic epidermal necrolysis." International Journal of Basic & Clinical Pharmacology 9, no. 3 (2020): 510. http://dx.doi.org/10.18203/2319-2003.ijbcp20200731.
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Toxic epidermal necrolysis (TEN) is a rare life-threatening adverse drug reaction associated with mucocutaneous eruptions and peeling of skin (sloughing) mostly caused by drugs like sulphonamides, beta lactams, carbamazepine and non-steroidal anti-inflammatory drugs (NSAIDs). Amoxicillin is a broad spectrum, bactericidal, Beta-lactam antibiotic used in treatment of various infections. Here by we have reported the case of amoxicillin induced severe toxic epidermal necrolysis. A Patient admitted in the hospital with the symptoms of epidermal sloughing that resulted in bare dermis as he received Amoxicillin drug for his diagnosis of fever. After clear examination TEN was confirmed and suspected with the cause due to Amoxicillin. The drug was stopped and patient was treated with other drugs for symptomatic cure. The patient was recovered from his condition and improved significantly.
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Udhnawala, Hiren, Hitesh Chaudhari, and Alpa Gor. "AMOXICILLIN+ CLAVULANIC ACID INDUCED TOXIC EPIDERMAL NECROLYSIS (TEN)." Journal of Health Sciences and Professions Education 1, no. 1 (2024): 59. https://doi.org/10.5455/jhspe.20240703060939.
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Amoxicillin, an antibiotic with broad-spectrum bactericidal properties and beta-lactam structure, demonstrates efficacy in treating various infections. Commonly reported adverse reactions include skin rashes and urticaria (3%), vomiting (1%), nausea (3%), diarrhea/loose stools (9%), and vaginitis (1%). According to statistics from the FDA, less than 3% of patients ceased therapy as a result of adverse reactions to their prescribed medications. "The predominant adverse effects linked to penicillin use predominantly involve hypersensitivity responses. Post-marketing surveys have revealed instances of exfoliative dermatitis, including erythema multiforme, pruritus, toxic epidermal necrolysis (TEN), serum sickness-like reactions (urticaria or skin rash accompanied by myalgia, arthritis, fever, and arthralgia), and angioedema." In order to reduce the risks associated with drug use and improve patient safety and welfare, the Pharmacovigilance Program of India (PvPI) was established. The Department of Pharmacology at Pramukh Swami Medical College in Karamsad is one of the ADR Monitoring Centers (AMCs), gathering ADRs as well as case studies and series to inform the public about rare adverse reactions of certain drugs. This case report gives details of a 72 year old Male who developed TEN following the use of the Fixed Dose Combination of Amoxicillin (500mg) + Clavulanic acid (125mg) to treat infection for the epididymo-orchitis. This case report adds and increases need for awareness of rare but serious side effects of Amoxicillin+ Clavulanic acid The report emphasizes on the active ADR monitoring of drugs which may cause serious side effects like TEN
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Mahendra Kumar, R., Sanatkumar Nyamagoud, Krishna Deshpande, and Ankitha Kotian. "Amoxicillin Induced Steven Johnson’s Syndrome: A Case Report." Journal of Drug Delivery and Therapeutics 10, no. 4-s (2020): 220–22. http://dx.doi.org/10.22270/jddt.v10i4-s.4205.
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Stevens-Johnson syndrome (SJS) is a very rare, potentially fatal skin reaction that is typically the result of reaction to the drug. In particular, SJS is characterized by extensive skin and mucous membrane lesions (i.e. mouth, nose, esophagus, anus, and genitalia), epidermis detachment, and acute skin blisters. In 95 % of case reports, drugs were found to be an important cause for the development of SJS. This story is a case of A 42 year old male hospitalized with rashes all over the body and fever, after oral consumption of Amoxicillin drug for sore throat. This case study discusses the possibility that serious hypersensitivity reactions with Amoxicillin can rarely occur and can be extremely harmful and life-threatening Menacing.
 Keywords: Toxic Epidermal Necrolysis, Stevens Johnson Syndrome, Adverse drug reaction, Nikolsky’s sign
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Krishna Kumar, Dhakchinamoorthi, Ravichandran Rajganesh, Dilli Batcha Jaya Shree, Sam Nikhil Cherian, and Thayub Mohamed. "Amoxicillin induced erythematous maculopapular rashes: a case report." International Journal of Basic & Clinical Pharmacology 9, no. 5 (2020): 806. http://dx.doi.org/10.18203/2319-2003.ijbcp20201763.
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Cutaneous adverse reactions (CAR) can occur with any class of drugs, however more widely caused by various antibiotics. Amoxicillin is a broad-spectrum, bactericidal, beta-lactam antibiotic, widely used for combating various infections. Cutaneous drug eruptions are known to be reported common while using penicillin class of drugs, specifically among children. These immune-mediated bizarre drug eruptions were range from mild to severe drug-induced cutaneous reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The present case reported with maculopapular, erythematous rashes induced by amoxicillin in a nine-year-old male patient. Amoxicillin was prescribed for his hyperactive respiratory disease and subsequently after three days developed generalized maculopapular erythematous rashes as a result of an antibiotic-induced skin rash. The present case is being reported to add more data, also to emphasize and gather the information for evidence-based practice and to promote efficient pharmacovigilance adverse drug reaction reporting.
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Banday, Muddasir Sharief, Sajad Ahmad Rather, Samina Mufti, and Sabia Qureshi. "Dermatological adverse drug reactions with particular reference to Steven-Johnson syndrome and toxic epidermal necrolysis." Asian Journal of Medical Sciences 14, no. 1 (2023): 104–9. http://dx.doi.org/10.3126/ajms.v14i1.48506.
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Background: Drug therapy is an inevitable cause of cutaneous adverse reactions. Aims and Objectives: The primary aim was to identify the incidence and magnitude of various dermatological adverse reactions including Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Moreover, secondary aim was to quantify the risks associated with the use of specific medications. Materials and Methods: A prospective and hospital-based study was conducted in the department of dermatology SMHS hospital on hospitalized cases of cutaneous adverse drug reactions (CADRs). Informed consent was sought and reactions were reported on validated questionnaire based on adverse drug reaction (ADR) monitoring form provided by Central Drug Standard Control organization Ministry of Health and Family Welfare, Government of India. These dermatological reactions were assessed for the clinical pattern, causative agents, and prognosis. The WHO-Uppsala Monitoring centre system for standardized case was used for causality assessment of all cases identified. Results: A total of 101 hospitalized patients with varied dermatological ADRs were reported during the study period. Cases were found more in females (n=75, 74.25%) than in males (n=26, 25.75%). CADRs that were reported in our study were exanthematous rash, fixed drug eruptions, urticarial rashes, SJS, TEN, urticarial vasculitis, anticonvulsant hypersensitivity syndrome, erythema multiforme, contact dermatitis, exfoliative dermatitis, mucosal hyperpigmentation, and nail pigmentation, respectively. After a meticulous drug history, the drugs implicated in causing the cutaneous reactions were anticonvalscents such as phenytoin, carbamazepine, lamotrigine, and phenobarbitone. Other drugs identified were non-steroidal anti-inflammatory drugs such as oxicam, antibiotics such as sulfasalazine, cefixime, cefpodoxime, amoxicillin, fluoroquinolones such as levofloxacin and ciprofloxacin, chemotherapeutic agents such as cyclophosphamide, 5FU, and hydroxurea. Conclusion: The present study concluded that skin is most common target for ADRs. Drug-induced cutaneous reactions can be as simple as a mild rash to rare life-threatening SJS and TEN. Moreover, certain group of patients is at increased risk for developing CADR’s as women are more susceptible than men.
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Parvathy, Shobha, and Messaline Sunitha. "Pattern of cutaneous adverse drug reactions in an adverse drug monitoring center at a tertiary care hospital in Kerala." National Journal of Physiology, Pharmacy and Pharmacology 13, no. 9 (2023): 434. http://dx.doi.org/10.5455/njppp.2023.13.12610202213012023.
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Background: Pre-marketing clinical trials can filter only about 50% of the drug reaction. Hence, to prevent the morbidity and mortality due to severe cutaneous reactions early detection, evaluation and monitoring of adverse drug reaction (ADR) especially cutaneous ADR (CADR) are mandatory. Hence, it is imperative that we update our knowledge of the precise nature of ADR which will prevent the reactions as well as to find the offending drug. Aim and Objectives: The aim of the study was to evaluate the pattern of CADR, the suspected drugs and to perform the causality assessment using WHO casualty assessment scale. Materials and Methods: A retrospective descriptive study was done using the data reported to ADR monitoring center in the Department of Pharmacology by the health-care professionals. Suspected CADR was diagnosed by the consultants concerned. The CADRs collected were categorized according to their morphology into maculopapupar rash (MPR), fixed drug eruptions (FDE), urticaria, Stevens-Johnson syndrome, and toxic epidermal necrolysis. The causality assessment was done using WHO Causality assessment scale. Results: The mean age was 47.20 + 22.31. The most common CADR reported was Urticaria 65.5% followed MPR 23%, FDE 8.8%, and Steven Johnsons Syndrome 2.2%. Anti-microbial drugs were the most frequent cause of the adverse reactions with Amoxicillin clavulinic acid combination being the most frequent suspected drug producing CADR (13.3%). The WHO causality assessment for majority of CADR was Possible (73.5%). Conclusion: Clinical Patterns of CADRs in this set up have some minor variations when compared to studies done across India. Amoxicillin clavulinic acid is the most common suspected drug in this study which was not frequently reported in other ADR monitoring centers.
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Zyryanov, Sergey, Irina Asetskaya, Olga Butranova, et al. "Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: Analysis of the Russian Database of Spontaneous Reports." Pharmaceuticals 17, no. 6 (2024): 675. http://dx.doi.org/10.3390/ph17060675.
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(1) Background: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are extremely severe cutaneous adverse drug reactions which are relatively rare in routine clinical practice. An analysis of a national pharmacovigilance database may be the most effective method of obtaining information on SJS and TEN. (2) Methods: Design—a retrospective descriptive pharmacoepidemiologic study of spontaneous reports (SRs) with data on SJS and TEN retrieved from the Russian National Pharmacovigilance database for the period from 1 April 2019 to 31 December 2023. Descriptive statistics was used to assess the demographic data of patients and the structure of suspected drugs. (3) Results: A total of 170 SRs on SJS and TEN were identified, of which 32.9% were SJS and 67.1%—TEN. In total, 30% were pediatric SRs, 21.2%—SRs of the elderly. There were 12 lethal cases, and all cases were TEN. The leading culprit drugs were anti-infectives for systemic use and nervous system agents. The top 10 involved drugs are as follows: lamotrigine (23.5%), ibuprofen (12.9%), ceftriaxone (8.8%), amoxicillin and amoxicillin with beta-lactam inhibitors (8.8%), paracetamol (7.6%), carbamazepine (5.9%), azithromycin (4.1%), valproic acid (4.1%), omeprazole (3.5%), and levetiracetam (3.5%). (4) Conclusions: Our study was the first study in Russia aimed at the assessment of the structure of the drugs involved in SJS and TEN on the national level.
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McDonald, Katherine A., and Tadeusz A. Pierscianowski. "A Case of Amoxicillin-Induced Acute Generalized Exanthematous Pustulosis Presenting as Septic Shock." Journal of Cutaneous Medicine and Surgery 21, no. 4 (2017): 351–55. http://dx.doi.org/10.1177/1203475417701421.
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This case report demonstrates the challenges of diagnosing and managing acute generalized exanthematous pustulosis (AGEP) presenting as septic shock. The disseminated, erythematous, pustular rash is a common feature. However, extensive organ involvement and life-threatening hypotension are unusual. The constellation of signs has not previously been documented following amoxicillin therapy. Toxic epidermal necrolysis (TEN) and toxic shock syndrome (TSS) were considered in addition to AGEP because of the systemic presentation. AGEP was diagnosed following histopathology (TEN was ruled out based on limited necrotic keratinocytes and lack of epidermal necrosis) and a negative antistreptolysin O titer (eliminated TSS). Antibiotic therapy for septic shock was provided before the diagnosis was confirmed as AGEP. Upon confirmation of the AGEP diagnosis, antibiotics were discontinued and a 5-day course of oral prednisone (40 mg/d) was initiated in addition to topical half-strength (0.05%) betamethasone valerate. The patient rapidly improved and was discharged. Outpatient patch testing confirmed amoxicillin as the culprit drug. In conclusion, it is critical to realize that AGEP cannot be ruled out with a septic shock presentation. Recent drug history is critical in recognizing an adverse drug reaction, and patch testing is useful for determining the culpable drug when the diagnosis is AGEP.
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Zanetti, Carlotta. "Wound care in a child suffering from Stevens-Johnson syndrome in PICU: case report." infermieristica journal 3, no. 1 (2024): 9–13. http://dx.doi.org/10.36253/if-2529.
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Stevens-Johnson Syndrome is considered a life-threatening adverse drug reaction. The pathogenesis of these syndromesis still unclear, but several drugs, such as anticonvulsivants and antibiotics, and especially sulfonamides, non-steroidal anti-infiammatorydrugs, and allopurinol were predominantly suspected of triggering this reaction. A 5-year-old boy patient who came to hospital attention for an urticarial reaction developed after taking amoxicillin, then a recent scarlet fever acquired by brother. Due to the worsening of the lesions, he was admitted to our PICU after being intubated for deterioration of the respiratory dynamics and safe treatment of secretions. Nursing care is crucial: care of patient hospitalized with Stevens-Johnson syndrome and Toxic Epidermal Necrolysis consists of wound care, infection prevention, comfort management, hydration and nutrition, psychosocial support, and prevention of long-term complications. For all patients with SJS and TEN, it is essential to perform a total body daily evaluation of the skin. If the dressings remain intact, it is advisable to note the appearance of visible skin and any visible exudate or staining on the outside of the intact dressings. If dressings are being removed or need to be reapplied daily, a full skin evaluation is useful.
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Nurrachmat Mulianto and Lifesia Natali Lidjaja. "Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Retrospective Study on Causative Agents and Patient Profiles in an Indonesian Hospital Setting." Bioscientia Medicina : Journal of Biomedicine and Translational Research 9, no. 7 (2025): 7967–80. https://doi.org/10.37275/bsm.v9i7.1327.
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Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent rare, severe mucocutaneous adverse drug reactions characterized by extensive epidermal necrosis and significant morbidity and mortality. Understanding the specific causative agents and patient profiles within local populations is crucial for early diagnosis and management. This study aimed to characterize SJS/TEN cases in a tertiary hospital setting in Indonesia. Methods: A retrospective descriptive study was conducted using secondary data from medical records of patients diagnosed with SJS, SJS/TEN overlap, and TEN admitted to the inpatient installation of Dr. Moewardi General Hospital, Surakarta, Indonesia, between January 2022 and December 2024. Data collected included demographics (age, gender), comorbidities, diagnosis classification (SJS, SJS/TEN overlap, TEN), suspected causative drugs, length of hospital stay, SCORTEN score, and patient outcome (discharged alive or deceased). Total sampling was employed, excluding records with incomplete data. Data were compiled and analyzed descriptively. Results: Fifty-one patients were included, with a slight female predominance (52.94%). The largest age group affected was 19-59 years (60.78%). The distribution of diagnoses was SJS (41.18%), SJS/TEN overlap (31.37%), and TEN (27.45%). The mean SCORTEN score for the cohort was 2. The most common suspected causative drug classes were antibiotics (25.71%), followed by analgesic-antipyretics (24.29%), and anticonvulsants (22.86%). Carbamazepine (11.43%) and amoxicillin (10%) were frequent individual culprits. Epilepsy (13.73%) and diabetes mellitus (11.76%) were common comorbidities, although a significant portion (33.33%) had no recorded comorbidity. The mean length of stay was 9 days. Overall mortality was 15.68%, with higher rates observed in TEN (28.57%) compared to SJS (9.52%) and SJS/TEN overlap (12.5%). Conclusion: SJS/TEN affected predominantly adults, with antibiotics, analgesics, and anticonvulsants being the most implicated drug classes. While mortality was considerable, it appeared lower than some international reports, particularly for TEN. Recognizing common causative agents and patient risk factors, such as specific comorbidities like epilepsy and diabetes, can aid clinicians in early identification and prompt management of these life-threatening conditions.
Dissertations / Theses on the topic "Toxic Epidermal Necrolysis Amoxicillin Adverse Drug Reactions"
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Oliveira, Ana Rita de Jesus. "Caracterização de Reações de Hipersensibilidade a Medicamentos." Master's thesis, 2017. http://hdl.handle.net/10316/83651.
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Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de Farmácia<br>A base da intervenção médica é a utilização de medicamentos que estão muitas vezes associados a complicações inerentes ao seu uso, sendo uma das principais causas da ocorrência de eventos adversos nos cuidados de saúde.A definição de RAM é vaga. Deve esclarecer-se que não são resultantes apenas da “utilização autorizada de um medicamento em doses normais, mas também dos erros terapêuticos e das utilizações fora dos termos da autorização de introdução no mercado, incluindo a utilização indevida e abusiva do mesmo”, como referido na diretiva 2010/84/UE.Para a presente análise de reações de hipersensibilidade a medicamentos, os dados recolhidos pertencem a um período de janeiro de 2009 a dezembro de 2014 e foram cedidos pela Unidade de Farmacovigilância de Coimbra. Para a sua recolha foi utilizado o Medical Dictionary for Regulatory Activities (MedDRA) query (versão 17.1). MedDRA é um dicionário de terminologia médica desenvolvido na década de 1990 pela International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH).Foram reportadas um total de 1278 notificações de RAM, das quais 3 relativas a SJS (prevalência de 0,23%), 2 relativas a NET (prevalência de 0,16%), 7 relativas a DRESS (prevalência de 0,55%) e 2 relativas a DILI (prevalência de 0,16%).Concluindo, unidades de farmacovigilância, como a UFC, onde são reportadas reações adversas a medicamentos representam uma fonte muito importante de informação da segurança dos medicamentos após a sua introdução no mercado e o seu uso sob condições não controladas. Desta forma é possível concluir à cerca da segurança dos medicamentos para a população, procedendo à sua retirada do mercado se assim for necessário.<br>The basis of medical intervention is the use of medications that are often associated with the inherent complications to their use, being one of the main causes of the occurrence of adverse events in health care.The definition of RAM is vague. It should be made clear that they are not only a result of “(...) the authorised use of a medicinal product at normal doses, but also from medication errors and uses outside the terms of the marketing authorisation, including the misuse and abuse of the medicinal product (...)", as referred to in Directive 2010/84/EU.For the present analysis of hypersensitivity reactions to medications, the collected data belong to a period from january 2009 to december 2014 and were ceded by the Pharmacovigilance Unit of Coimbra. The Medical Dictionary for Regulatory Activities (MedDRA) query (version 17.1) was used for its collection. MedDRA was developed by the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH), in the late 1990s.A total of 1278 notifications of RAM were reported, of which 3 on the SJS (prevalence of 0.23%), 2 on the NET (prevalence of 0.16%), 7 concerning DRESS (prevalence of 0.55%) and 2 relating to DILI (prevalence of 0.16%).In conclusion, pharmacovigilance units, such as the Pharmacovigilance Unit of Coimbra, where adverse drug reactions are reported represent a very important source of drug safety information after their placing on the market and their use under uncontrolled conditions. In this way, it is possible to conclude about the drug safety for the population and to remove them from the market if necessary.
Book chapters on the topic "Toxic Epidermal Necrolysis Amoxicillin Adverse Drug Reactions"
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Roujeau, Jean-Claude. "Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (Epithelial Necrolysis)." In Advances in Diagnosis and Management of Cutaneous Adverse Drug Reactions. Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-13-1489-6_6.
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Abe, Riichiro. "Cutaneous Adverse Drug Reactions: Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis." In Immunology of the Skin. Springer Japan, 2016. http://dx.doi.org/10.1007/978-4-431-55855-2_24.
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"Cutaneous adverse drug reactions." In Paediatric Dermatology, edited by Sue Lewis-Jones and Ruth Murphy. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198821304.003.0023.
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Cutaneous adverse drug reactions considers the principle types of unwanted responses to drugs seen on the skin. The most common exanthematous rash is examined as are serious eruptions such as Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) along with other reactions. The clinical manifestations are discussed along with likely causative agents. Practical advice about severity, worrying features, and management is given.
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Walsh, Sarah, Daniel Creamer, and Haur Yueh Lee. "Cutaneous reactions to drugs." In Oxford Textbook of Medicine, edited by Roderick J. Hay. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0565.
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Adverse reactions to medications are common and important cause of iatrogenic illness. Severe cutaneous adverse drug reactions include toxic epidermal necrolysis, Stevens–Johnson syndrome, drug reaction with eosinophilia and systemic symptoms, and acute generalized exanthematous pustulosis, which together constitute 2% of all adverse drug reactions and may be life-threatening. Less severe drug-induced skin reactions such as exanthems, urticaria, lichenoid drug rashes, and fixed drug eruptions are more common, sometimes termed benign cutaneous adverse reactions, and generally resolve without sequelae. Drugs may also cause adverse events due to alteration of the normal function of the skin or its appendages. This may take the form of photosensitivity, abnormal pigmentation, or disrupted growth of hair or nails.
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H. Tran, Thi. "Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis." In Blistering Skin Disorders [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102794.
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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions (SCARs). The most common causative drugs of SJS/TEN are allopurinol, carbamazepine, abacavir, phenytoin, and lamotrigine. SJS/TEN are categorized based on the percentage of epidermal detachment area: (i) SJS: less than 10%, (ii) TEN: greater than 30%, (iii) and overlapping SJS/TEN: 10–30%. The pathogenesis of SJS/TEN is not fully understood, but some immunological and genetic factors are believed to be involved. There is a strong association between some specific HLA haplotypes and drug-induced SJS/TEN, for example, HLA-B*15:02 and carbamazepine-, HLA-B*58:01 and allopurinol. CD8+ cytotoxic T cells and natural killer (NK) cells play an important role in the pathogenesis of SJS/TEN, and upon the activation, they produce cytokines, chemokines, and cytotoxic proteins, that cause extensive keratinocytes apoptosis. Systemic corticosteroid and cyclosporine are still used as the first line in the treatment of SJS/TEN, in combination with care support.
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Asadi-Pooya, Ali A., and Michael R. Sperling. "Antiseizure Medications and Cutaneous Reactions." In Antiseizure Medications, 3rd ed. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197541210.003.0027.
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Abstract Idiosyncratic drug reactions are unexpected and unpredictable adverse reactions that are fundamentally different from the dose-related adverse effects of drugs. Drug-induced rashes are the most common type of idiosyncratic reaction caused by the use of antiseizure medications (ASMs). Most reactions are mildly to moderately uncomfortable rashes without systemic involvement, but occasionally the rash can be severe and present as erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis (Lyell syndrome). The ASM hypersensitivity syndrome (AHS), also known as drug reaction with eosinophilia and systemic symptoms (DRESS), is not common, but is important and potentially life-threatening. All cutaneous reactions to ASM administration must be evaluated promptly.
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Rajaram Maurya, Miteshkumar, Renuka Munshi, Sachin Bhausaheb Zambare, and Sanket Thakur. "Drug-Induced Severe Cutaneous Adverse Reactions, Diagnostics and Management." In Immunosuppression and Immunomodulation [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.108651.
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Severe cutaneous Adverse Reactions (SCAR) are rare drug hypersensitivity reactions but can be life-threatening if not appropriately and timely managed. Many research studies have shed light on its pathomechanism and triggers that have helped us better understand SCAR. The presence of viral fever and genetics such as HLA genotype with certain drugs have been associated with the occurrence of SCAR. However, the basis of interaction of these causative agents needs further evaluation to understand the predisposition to the reaction occurrence. The different spectrum of SCAR needs to be clinically diagnosed appropriately which includes Drug Reactions with Eosinophilia and Systemic Symptoms (DRESS), Steven Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN), Acute Generalized Exanthematous Pustulosis (AGEP), and generalized bullous fixed drug eruptions (GBFDE). However, due to the rare occurrence of this reaction, there is not sufficient evidence for the best treatment for patients suffering from SCAR. Our review provides detailed information about the disease type, manifestation, pathophysiology, diagnostics, and current treatment aspects of SCAR.
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Satapornpong, Patompong, Lisa Vorasatit, and Shoban John. "Advances in Clinical Pharmacogenomics and Prevention of Severe Cutaneous Adverse Drug Reactions in the Era of Precision Medicine." In Personalized Medicine - New Perspectives [Working Title]. IntechOpen, 2024. http://dx.doi.org/10.5772/intechopen.1003691.
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Severe cutaneous adverse drug reactions (SCARs), including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), are rare but severe life-threatening adverse drug reactions. Although their incidence is rare, the mortality rates are as high as 10% for DRESS, 1–5% for SJS and 25–50% for TEN. Recent studies have suggested that HLA genes are associated with SCARs during treatment with causative medicines. The HLA gene is located on chromosome 6p21.1–21.3 and consists of HLA class I, II and III. Interestingly, HLA-pharmacogenomic markers influence these mechanisms of immunopathogenesis in culprit drug-induced SCARs. However, due to genetic differences at the population level, drug-induced SCARs are varied; thus, the specific pharmacogenomic markers for ethnicity might differ among populations. For instance, the HLA-A*31:01 allele is associated with carbamazepine-induced SCARs in Europeans and Japanese individuals, while the HLA-B*15:02 allele is associated with carbamazepine-induced SJS-TEN among Thais, Han Chinese, Taiwanese and Southeast Asians populations. Such differences pose a major challenge to preventing SCARs. Therefore, knowledge of the pharmacogenomics, mechanisms of immunopathogenesis and ethnic-specific genetic variation related to drug-induced SCARs is needed.
Reports on the topic "Toxic Epidermal Necrolysis Amoxicillin Adverse Drug Reactions"
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Severe Cutaneous Adverse Reactions. A consensus by a CIOMS Working Group. CIOMS, 2025. https://doi.org/10.56759/lrty1600.
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In clinical practice, there is mounting concern about the burden of SCAR in relation to novel biologics as well as the increasing cost of diagnosis and management. This consensus report provides unique insights and the latest thinking from renowned experts on this important topic. The skin is among the parts of the body most commonly affected by adverse drug reactions (ADRs). Cutaneous ADRs affect 2% to 3% of all hospitalized patients and have a wide spectrum of clinical manifestations, are caused by various medicinal products, and result from different pathophysiologic mechanisms. Hence, their diagnosis and management are challenging. However, approximately 0.1% to 1% of patients with medicinal product eruptions have serious ADRs which can lead to disabling sequelae and in some cases, fatalities. Although Severe Cutaneous Adverse Reactions (SCAR) are rare, they are a significant health challenge and hinder the safe and effective use of medicines. In short, they pose substantial hurdles to drug developers, medicines regulators and health professionals. SCAR include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed drug eruptions (GBFDE). Premarketing randomized clinical trials have limited power to detect SCAR. There is also a lack of specific diagnostic tests for SCAR, which today, depend on subjective causality assessment methods. These factors highlight the urgent need for guidelines, including how to predict, prevent, detect and diagnose SCAR either during drug development or in the post-marketing phase.