Treatment of toxic epidermal necrolysis with the combination of infliximab and high-dose intravenous immunoglobulin

Dermatology : International Journal for Clinical and Investigative Dermatology
Georgios GaitanisIoannis D Bassukas

Abstract

Therapeutic evidence for toxic epidermal necrolysis (TEN) is indicative for high-dose intravenous immunoglobulin yet inconclusive for corticosteroids. To describe the combination of corticosteroids, infliximab and a high-dose intravenous immunoglobulin course for TEN. In three patients (SCORTEN survival probabilities: 41.7%, 64.2%, 41.7%) disease control was evaluated by (a) employing quantitative image analysis to measure progression of skin detachment and (b) patients' outcome (complete re-epithelization). Published cases of TEN treatments with infliximab were retrieved from PubMed. Within 48 h skin disease progression was arrested in all patients. Two patients were discharged after 3 weeks without any sequels from skin or conjunctivae. One patient passed away on the ninth day, however with noticeably improved skin (mortality rate: 33% observed vs. 50% expected). A PubMed search retrieved five TEN patients treated successfully with infliximab. The described combination presents a feasible therapeutic alternative for TEN that warrants further evaluation.

Citations

Nov 22, 2013·Asia Pacific Allergy·Bernard Yu-Hor Thong
Dec 22, 2012·Case Reports in Dermatological Medicine·Konstantinos PatmanidisIoannis D Bassukas
Oct 7, 2014·Indian Journal of Dermatology·Virendra N SehgalAnanta Khurana
Apr 15, 2014·Burns : Journal of the International Society for Burn Injuries·Philippe PaquetGérald E Piérard
Oct 2, 2012·Skin Research and Technology : Official Journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI)·Panagiota SpyridonosMargaret Tzaphlidou
Jun 15, 2014·Journal of the American Academy of Dermatology·Andrea ParadisiBiagio Didona
Sep 1, 2016·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·O N HorváthM Sárdy
May 1, 2018·Journal of the European Academy of Dermatology and Venereology : JEADV·S VuralJ C Prinz
Jun 19, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Jutamas TankunakornKumutnart Chanprapaph
May 20, 2020·Ophthalmic Plastic and Reconstructive Surgery·Nina JovanovicAlon Kahana

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