Treatment of toxic epidermal necrolysis with intravenous immunoglobulin: a series of three cases

Stevens-Johnson's syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatoses, that lead to keratinocyte apoptosis induced by interactions between Fas (cell death receptor) and soluble Fas-ligand, present in serum of Stevens-Johnson's syndrome / toxic epidermal necrolysis patients. Anti-Fas antibodies in intravenous immunoglobulin (IVIG) would block the apoptosis cascade. Three cases of toxic epidermal necrolysis occurred in one male and two female patients, after use of allopurinol, leprosy multidrug therapy concomitant with dipyrone, and diclofenac. The cases were treated with intravenous immunoglobulin 2-3 mg/kg and prednisone 20-50 mg/day. The interruption of new lesions outbreak and reepithelization were extremely fast after the use of intravenous immunoglobulin, without adverse effects. Controlled studies are needed to confirm the efficacy of intravenous immunoglobulin in Stevens-Johnson's syndrome / toxic epidermal necrolysis, but the results seem promising.

Bibliographic Details

Main Authors:	Comparin,Cristiane, Hans Filho,Günter, Takita,Luiz Carlos, Costa,Nayara de Castro Wiziack, Nascimento,Roberta Ayres Ferreira do, Nanni,Lidiane de Oliveira Costa
Format:	Digital revista
Language:	English
Published:	Sociedade Brasileira de Dermatologia 2012
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962012000300022
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