• Journal of Oral Medicine and Pain
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• 제22권1호
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• pp.23-29
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• 1997

A 49 years old male patient was referred from the Department of Medicine, KNUH for the management of painful oral lesions. The patient had disability of food and drug intake due to multiple intraoral ulcers. Extraoral findings showed upper and lower lip swelling, crust formation on the lips. The lesions were diagnosed as Stevens-Johnson syndrome based on clinical and hematologic findings. The patient was treated with saline irrigation and pulsed Nd:YAG laser irradiation. After 5 daily treatment, the lesions decreased in size and severity, and the patient became more comfortable for food intake and speeching. It was suggested from the results of this clinical trial that a pulsed Nd:YAG laser therapy would be helpful for the symptoms associated with Stevens-Johnson syndrome.

• IMMUNE NETWORK
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• 제16권4호
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• pp.256-260
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• 2016

An association between drug treatment for viral infections and severe cutaneous adverse reactions has been noted. We investigated six patients diagnosed with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) after being prescribed acetaminophen for suspected viral illnesses. Multiplex analysis was performed to measure cytokine levels in sera before and after treatment. IL-2Ra levels significantly decreased during the convalescence phase. Although acetaminophen is relatively safe, the drug can trigger SJS/TEN in patients with suspected viral infections. T-cells and monocytes may be key components of the link between viral infection and acetaminophen-induced SJS/TEN.

• Childhood Kidney Diseases
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• 제18권2호
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• pp.123-127
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• 2014

다형 홍반은 피부, 구강, 입술 및 생식기 등을 침범하는 급성 피부점막 질환으로 점막 침범 여부에 따라 다형 홍반 minor와 다형 홍반 major로 분류된다. 스티븐스-존슨 증후군과 독성표피괴사용해는 다형 홍반 major에 속하는데, 이들은 증상이 심하고 진행성이며 높은 사망률을 보인다. 코르티코스테로이드는 현재 다형 홍반의 치료제로 사용되고 있다. 저자들은 신증후군을 가진 소아 환자에서 경구 코르티코스테로이드인 데플라자코트를 사용하던 중 발생된 3개의 다형 홍반 증례를 보고하는 바이다.

• 한국임상약학회지
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• 제23권4호
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• pp.344-364
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• 2013

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.

• Journal of Oral Medicine and Pain
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• 제36권2호
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• pp.99-105
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• 2011

홍순(red zone 또는 vermilion zone)은 해부학적으로 입술의 피부부위에서 구강점막으로 이행되는 부위로 선 구순염, 접촉구순염, 구각 구순염, 형질세포성 구순염, 박탈성 구순염, 광선 구순염, 육아종성 구순염과 같은 염증성 질환으로 알려진 다양한 구순염과 감염성 질환, 양성 및 악성 종양, 다른 전신질환의 피부증상과 관련된 병소들이 나타난다. 본 증례에서는 홍순에 발생한 궤양성, 출혈성, 가피를 형성한 병소들에 대해 형질세포 구순염과 Stevens-Johnson syndrome(SJS)과 관련된 홍순 병소를 경험한 바 이를 보고하고자 한다.

• 대한소아치과학회지
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• 제44권4호
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• pp.455-460
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• 2017

스티븐 존슨 증후군(Stevens-Johnson syndrome, SJS)은 피부와 점막에 광범위한 괴사를 초래하는 매우 심각한 급성 과민반응이다. SJS은 모든 연령대에서 발생할 수 있는 질환으로 원인은 명확하지는 않지만 대부분 약물 알레르기에 의한 것으로 알려져 있으며 그 외에도 세균감염에 의해 유발되기도 한다고 알려져 있다. 전체 표피면적의 10% 이하에서 병변이 발생한 경우를 SJS라 하며 30% 이상에서 발생한 경우를 독성 표피 괴사융해라 정의한다. SJS는 1년에 100만명 인구 당 1 - 2명 미만에서 드물게 발생하나, 성장기 어린아이에게 발생할 경우 치아발육 등에 미치는 영향을 미치게 된다. 6 - 7세경 상하악 제1대구치와 하악중절치의 맹출이 시작되고 이 시기에 치근의 발육이 함께 일어난다. 이 케이스의 환아의 경우 6세경 SJS이 발병하였다. 현재 완치된 상태이나 몇몇 후유증이 남아있는 상태이다. 환아는 이 시기에 발육이 완성되는 치아에 국한되어 발육이상이 관찰되었다. 구강내 특징으로 이러한 전신질환을 진단하고 이로 인한 치아 발육에 대한 영향에 대한 문제점을 인식하고 해결하고자 이 보고서를 쓰는 바이다.

• Journal of Interdisciplinary Genomics
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• 제3권1호
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• pp.7-12
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• 2021

Adverse drug reactions (ADRs) is a hypersensitivity reactions to specific medications, and remain a common and major problem in healthcare. ADRs suchc as drug-induced liver injury and life-threatening severe cutaneous adverse drug reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug rash with eosinophilia and systemic symptoms can be occurred by uncontrolled expansion of oligoclonal T cells according to genetically predisposing HLA. In this review, I summarized the alleles of HLA genes which have been proposed to have association with ADRs caused by different drugs.

• 한국치위생학회지
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• 제8권4호
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• pp.31-41
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• 2008

Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis(TEN) are severe mucocutaneous reaction which are most frequently caused by drugs. Although the incidence of SJS and TEN is known to be relatively low, outcomes may be fatal. A systematic approach is required because morbidity rate is currently increasing and oral lesion is frequent. We investigated the clinical features and outcomes of 6 patients diagnosed as SJS and TEN and referred from the department of dermatology, Chonnam National University Hospital for oral care. Ketoconazol, Ofloxacin, Chlorphenesin, Amoxicillin, Pontal, Harnal, and Ciprofloxacin were suspected as the causative drugs. Average treatment period was 3.2 weeks, and two patients were referred to 'burn-patients' hospital. Most of oral lesion were cured be normal tissue, but scares with discoloration were observed. For intraoral management, antibiotic disinfection and steroid application were performed according to systemic treatment principles. Additionally, ingestion of zinc, antioxidants, and vitamin was recommended. The establishment of oral treatment principles is demanded because it has not been yet. Also, through investigation of drug side effect and careful prescription are required.

• 한국산업보건학회지
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• 제17권3호
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• pp.254-260
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• 2007

Trichloroethylene(TCE) is widely used as a degreasing solvent in workplaces. TCE is primarily toxic to the nervous system, however, systemic disorder like Stevens-Johnson syndrome has been recently reported in small-scale factories, where the government has had limited information of chemical use. A survey was performed to investigate the actual condition of using TCE and to provide practical information to occupational health service agencies and professionals. This survey was carried out on 103 factories out of 430 factories which were conducted periodic work environment measurement for TCE. Degreasing was the most popular reason for using TCE in Korea, which reached to 94%. TCE was also used as a solvent for rubber in the coating or molding process, and adhesives in the bonding process. Metal fabrication was the most common as 23%, followed by assembling automobile parts (17%), and machinery (12%). Workers exposed to TCE during full-shift were 52% while 48% were exposed during short period of the shift or intermittently. Manual or semi-automatic work occupied 87% while automatic work was just 13%. Though automatic work by a closed system was generally lower exposed to TCE, compared to manual work, it can cause a high exposure when the maintenance system is improper. Semi-automatic work especially like open-top degreasing process can cause a high exposure when local exhaust system with condensing and refrigerating coils in the degreaser does not work well. In conclusion, the survey showed nationwide status of TCE exposure in various aspects. It can be used to monitor workplaces and workers exposed to TCE to prevent occupational diseases.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.437-441
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• 2010

독성표피괴사용해(TEN)와 스티븐-존슨 증후군(SJS)은 약물이나 감염에 의해 발생하는 피부점막을 침범하는 드물지만 치명적인 질병이다. 스테로이드는 TEN의 치료에 많이 이용되어왔지만, 아직까지도 논쟁중이다. 스테로이드에 의한 정신과적 영향은 두통, 불면증, 우울증, 심리질환 등이 있다. 스테로이드에 의한 정신질환에서 치료는 스테로이드의 감량 또는 중단이고, 항정신성 약물을 투여한다. 신증후군으로 진단된 11세 남아에서 스테로이드 치료 후 관해상태에서 유지치료를 시행하고 있던 중에 TEN이 발생하였다. 저자들은 이 환아에서 치료목적으로 투여한 고용량 스테로이드 정맥주사로 인해 정신질환이 동반되었고, 이후 스테로이드 감량과 항정신성 약물과 면역글로불린으로 증상이 호전되는 것을 경험하여 이를 보고하는 바이다.