Comment on: Proposal for a new diagnostic classification of
Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap (SJS/TEN), collectively referred to SJS/TEN, form a spectrum of severe life-threatening adverse drug reactions whose pathomechanism is not fully understood. The article "Photodistributed Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Proposal for a New Diagnostic Classification" by McKinley et. al., discusses a distinct distribution of epidermal necrosis in SJS/TEN, attributable to preceding exposure to ultraviolet radiation (UVR), and relative sparing of photo-protected areas. After reviewing numerous cases within the Immune-mediated Adverse drug Reactions in African HIV endemic setting Register and Biorepository (IMARI-SA) at the University of Cape Town with a similar clinical pattern as those published by McKinley et. al., we propose that the relative sparing of some areas giving an impression of photo-distribution is due to localised increase in skin pressure that reduces the blood supply in that area below a critical threshold. A dip in blood supply below this critical threshold quantitively limited T lymphocytes and cytokines that drive SJS/TEN to reach and damage the skin.
Nicole Michels's research works Rocky Vista University, Parker and other places
Biobank sample workflow. Residual samples are biospecimens that are
Sites in The Gambia (left) and Kenya (right).
Biobank sample workflow. Residual samples are biospecimens that are
100179 PDFs Review articles in ULTRAVIOLET RAYS
PDF) Photodistributed Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and proposal for a new diagnostic classification
7235 PDFs Review articles in TOXIC EPIDERMAL NECROLYSIS
294604 PDFs Review articles in SYSTEMATIC REVIEWS
100179 PDFs Review articles in ULTRAVIOLET RAYS
Mean posterior probabilities from combined traces (circles) for C.
Biobank sample workflow. Residual samples are biospecimens that are