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Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular...

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Autores principales: Shanbhag, Swapna S., Sangwan, Virender S., Singh, Aastha, Donthineni, Pragnya R., Basu, Sayan, Srinivasan, Bhaskar, Agarwal, Shweta, Iyer, Geetha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429498/
https://www.ncbi.nlm.nih.gov/pubmed/34513854
http://dx.doi.org/10.3389/fmed.2021.643955
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author Shanbhag, Swapna S.
Sangwan, Virender S.
Singh, Aastha
Donthineni, Pragnya R.
Basu, Sayan
Srinivasan, Bhaskar
Agarwal, Shweta
Iyer, Geetha
author_facet Shanbhag, Swapna S.
Sangwan, Virender S.
Singh, Aastha
Donthineni, Pragnya R.
Basu, Sayan
Srinivasan, Bhaskar
Agarwal, Shweta
Iyer, Geetha
author_sort Shanbhag, Swapna S.
collection PubMed
description Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease.
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spelling pubmed-84294982021-09-11 Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India Shanbhag, Swapna S. Sangwan, Virender S. Singh, Aastha Donthineni, Pragnya R. Basu, Sayan Srinivasan, Bhaskar Agarwal, Shweta Iyer, Geetha Front Med (Lausanne) Medicine Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease. Frontiers Media S.A. 2021-08-27 /pmc/articles/PMC8429498/ /pubmed/34513854 http://dx.doi.org/10.3389/fmed.2021.643955 Text en Copyright © 2021 Shanbhag, Sangwan, Singh, Donthineni, Basu, Srinivasan, Agarwal and Iyer. 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 Medicine
Shanbhag, Swapna S.
Sangwan, Virender S.
Singh, Aastha
Donthineni, Pragnya R.
Basu, Sayan
Srinivasan, Bhaskar
Agarwal, Shweta
Iyer, Geetha
Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India
title Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India
title_full Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India
title_fullStr Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India
title_full_unstemmed Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India
title_short Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India
title_sort clinical aspects of stevens-johnson syndrome/toxic epidermal necrolysis with severe ocular complications in india
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429498/
https://www.ncbi.nlm.nih.gov/pubmed/34513854
http://dx.doi.org/10.3389/fmed.2021.643955
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