Erythema multiforme and toxic epidermal necrolysis
Erythema multiforme and toxic epidermal necrolysis
Erythema multiforme and toxic epidermal necrolysis
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EM/SJS/TEN therapy<br />
The most important factor in the therapy of EM/SJS/TEN is investigation <strong>and</strong> elimination of the triggering<br />
factors. 5, 8 When this is accomplished, the symptoms are usually resolved within 1–2 weeks. 8 In idiopathic<br />
cases of EM/SJS/TEN, a large dose of glucocorticoids with azathioprine <strong>and</strong>/or cyclosporine A may improve<br />
clinical signs. However, in human medicine, the use of glucocorticoids for treatment of EM/SJS/TEN has<br />
been controversial as their use may elicit systemic infection. 2, 9 The use of human immunoglobulin by<br />
intravenous injection for the treatment of canine SJS/TEN is thought to be beneficial for the treatment of the<br />
condition. 5<br />
References<br />
1. Affolter VK, Moore PF, S<strong>and</strong>maier BM. Immunohistochemical characterization of canine acute graft-versus-host<br />
disease <strong>and</strong> erythema <strong>multiforme</strong>. Advances in Veterinary Dermatology 1998; 3:103-115<br />
2. Borchers AT, Lee JL, Naguwa SM, Cheema GS, Gershwin E. Stevens-Johnson syndrome <strong>and</strong> <strong>toxic</strong> <strong>epidermal</strong><br />
<strong>necrolysis</strong>. Autoimmunity Reviews. 2008; 7: 598-605<br />
3. Hinn AC, Olivry T, Luther PB, Cannon AG, Yager JA. <strong>Erythema</strong> <strong>multiforme</strong>, Stevens-Johnson syndrome, <strong>and</strong> <strong>toxic</strong><br />
<strong>epidermal</strong> <strong>necrolysis</strong> in the dog; Clinical presentation, drug exposure, <strong>and</strong> histopathologic correlations. Journal of<br />
Veterinary Allergy <strong>and</strong> Clinical Immunology 1998; 6:13-<br />
4. Mason K, Fadok V. Cutaneous drug eruption with <strong>epidermal</strong> necrosis: A discussion of pathophysiologic <strong>and</strong><br />
comparative aspects. Clinics in Dermatology 1994; 12: 525-528<br />
5. Noli C, von Tscharner C, Suter M. Apoptosis in selected skin diseases. Veterinary Dermatology 1998; 9: 221-229<br />
6. Nuttal TJ, Malham T. Successful intravenous human immunoglobulin treatment of drug-induced Stevens-Johnson<br />
syndrome in a dog. Journal of Small Animal Dermatology 2004; 45: 357-361<br />
7. Scott DW, Miller W, Griffin C. <strong>Erythema</strong> <strong>multiforme</strong>. In: Small Animal Dermatology 6 th ed. Philadelphia Saunders,<br />
2001: 732-742<br />
8. Scott DW, Miller W. <strong>Erythema</strong> <strong>multiforme</strong> in dogs <strong>and</strong> cats: literature review <strong>and</strong> case material from the Cornell<br />
University College of Veterinary Medicine (1988-1996), Veterinary Dermatology 1999; 10: 297-309<br />
9. Sontheimer RD. Lichenoid tissue reaction/interface dermatitis: Clinical <strong>and</strong> histological perspectives. Journal of<br />
Investigative Dermatology 2009; 129: 1088-1099<br />
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