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Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog

Toxic epidermal necrolysis (TEN) is a rare and severe life-threatening syndrome characterized by apoptosis of keratinocytes resulting in devitalization of the epidermis affecting more than 30% of skin surface. In humans and animals, this condition is mostly triggered by drugs. Identification of the...

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Autores principales: Lecru, Line-Alice, Combarros, Daniel, Castilla-Castaño, Eloy, Delverdier, Maxence, Cadiergues, Marie-Christine, Pressanti, Charline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417874/
https://www.ncbi.nlm.nih.gov/pubmed/34490405
http://dx.doi.org/10.3389/fvets.2021.728901
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author Lecru, Line-Alice
Combarros, Daniel
Castilla-Castaño, Eloy
Delverdier, Maxence
Cadiergues, Marie-Christine
Pressanti, Charline
author_facet Lecru, Line-Alice
Combarros, Daniel
Castilla-Castaño, Eloy
Delverdier, Maxence
Cadiergues, Marie-Christine
Pressanti, Charline
author_sort Lecru, Line-Alice
collection PubMed
description Toxic epidermal necrolysis (TEN) is a rare and severe life-threatening syndrome characterized by apoptosis of keratinocytes resulting in devitalization of the epidermis affecting more than 30% of skin surface. In humans and animals, this condition is mostly triggered by drugs. Identification of the putative agent and its withdrawal are crucial to successful management of a patient with TEN. In this case study, we report the clinical features, histopathological findings and management of a dog with TEN. A 4-year-old intact male French bulldog presented with acute onset of severe lethargy and cutaneous ulcerations on the footpads, scrotum, and hind limbs associated with marked pain. A Stevens-Johnson syndrome/TEN was suspected and drugs, especially beta-lactams, were withdrawn. Histopathology confirmed the diagnosis of epidermal necrosis. Advanced supportive therapy, pain management and skin care led to rapid remission. Early identification and removal of the suspected medication was crucial to improving TEN prognosis in this dog. Antibiotics (penicillin, ampicillin, cephalexin, and sulfonamides) are frequently involved in adverse cutaneous reactions in dogs. Ideal treatment remains elusive is humans and dogs and this disease has a poor prognosis. Supportive care combined with pain management and treatment of the cutaneous ulcerations is essential.
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spelling pubmed-84178742021-09-05 Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog Lecru, Line-Alice Combarros, Daniel Castilla-Castaño, Eloy Delverdier, Maxence Cadiergues, Marie-Christine Pressanti, Charline Front Vet Sci Veterinary Science Toxic epidermal necrolysis (TEN) is a rare and severe life-threatening syndrome characterized by apoptosis of keratinocytes resulting in devitalization of the epidermis affecting more than 30% of skin surface. In humans and animals, this condition is mostly triggered by drugs. Identification of the putative agent and its withdrawal are crucial to successful management of a patient with TEN. In this case study, we report the clinical features, histopathological findings and management of a dog with TEN. A 4-year-old intact male French bulldog presented with acute onset of severe lethargy and cutaneous ulcerations on the footpads, scrotum, and hind limbs associated with marked pain. A Stevens-Johnson syndrome/TEN was suspected and drugs, especially beta-lactams, were withdrawn. Histopathology confirmed the diagnosis of epidermal necrosis. Advanced supportive therapy, pain management and skin care led to rapid remission. Early identification and removal of the suspected medication was crucial to improving TEN prognosis in this dog. Antibiotics (penicillin, ampicillin, cephalexin, and sulfonamides) are frequently involved in adverse cutaneous reactions in dogs. Ideal treatment remains elusive is humans and dogs and this disease has a poor prognosis. Supportive care combined with pain management and treatment of the cutaneous ulcerations is essential. Frontiers Media S.A. 2021-08-20 /pmc/articles/PMC8417874/ /pubmed/34490405 http://dx.doi.org/10.3389/fvets.2021.728901 Text en Copyright © 2021 Lecru, Combarros, Castilla-Castaño, Delverdier, Cadiergues and Pressanti. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Veterinary Science
Lecru, Line-Alice
Combarros, Daniel
Castilla-Castaño, Eloy
Delverdier, Maxence
Cadiergues, Marie-Christine
Pressanti, Charline
Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog
title Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog
title_full Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog
title_fullStr Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog
title_full_unstemmed Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog
title_short Case Report: Positive Outcome of a Suspected Drug-Associated (Immune Mediated) Reaction in a 4-Year-Old Male French Bulldog
title_sort case report: positive outcome of a suspected drug-associated (immune mediated) reaction in a 4-year-old male french bulldog
topic Veterinary Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417874/
https://www.ncbi.nlm.nih.gov/pubmed/34490405
http://dx.doi.org/10.3389/fvets.2021.728901
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