Lyell’s Disease – a Case Report
Authors:
R. Kiszová 1; D. Cholevík 1; J. Timkovič 1; T. Zaoral 2; I. Zámečníková 3
Authors place of work:
Oční klinika, FN Ostrava, přednosta MUDr. Petr Mašek, CSc.
1; Klinika dětského lékařství, FN Ostrava, přednosta doc. MUDr. Michal Hladík, Ph. D.
2; Popáleninové centrum, FN Ostrava, primář MUDr. Iva Zámečníková
3
Published in the journal:
Čes. a slov. Oftal., 67, 2011, No. 3, p. 104-106
Category:
Case Report
Summary
Lyell’s disease is a rare, life-threatening, acute dermatologic disease. The mucous membranes are also often involved. Nearly all cases are induced by medications. There is currently no specific treatment and interdisciplinary cooperation is very important. The authors present a case report of a 15 year old boy with the ocular manifestations of Lyell’s disease, triggered by lamotrigine. He was admitted to the burn unit with involvement of 85% of his body surface area. Ocular manifestations documented during hospitalization were classified as mild (lid edema, conjunctival injection) and later severe (multiple symblepharons). The patient was treated with antibiotic eyedrops/ointment, corticosteroid eyedrops/ointment, topical lubricants and a glass rod was used to lyse the symblepharons. At 23 months of follow-up our patient had a symblepharon which blocked the superior and inferior punctum in both eyes, without conjunctival fornix foreshortening or corneal abnormalities, minimal ocular discomfort.
Key words:
Lyell’s disease, toxic epidermal necrolysis, symblepharon
Zdroje
1. Becker, D.S.: Toxic epidermal necrolysis. Lancet, 1998; 351: 1417–1420.
2. Halebian, P.H., Corder, V.J., Madden, M.R. et al.: Improved burn center survival of patients with toxic epidermal necrolysis managed without corticosteroids. Ann Surg., 1986; 204(5): 503–512.
3. Hanken, I., Schimmer, M., Sander, C.A.: Basic measures and systemic medical treatment of patients with toxic epidermal necrolysis. J Dtsch Dermatol Ges., 2010; 8(5): 341–346.
4. Chang, Y.S., Huang, F.C., Tseng, S.H. et al.: Erythema multiforme, Stevens–Johnson syndrome and toxic epidermal necrolysis: acute ocular manifestations, causes and management. Cornea, 2007; 26: 123–129.
5. Lissia, M., Mulas, P., Bulla, A. et al.: Toxic epidermal necrolysis (Lyell’s disease). Burns, 2010; 36: 152–163.
6. Lyell, A.: Toxic epidermal necrolysis: an eruption resembling scalding of the skin. Br J Dermatol, 1956; 68 (11): 355–361.
7. Paquet, P., Pierard, G.E., Quatresooz, P.: Novel treatments for drug-induced toxic epidermal necrolysis (Lyellęs syndrome). Int Arch Allergy Immunol, 2005; 136 (3): 205–216.
8. Power, W.J., Ghoraishi, M., Merayo-Lloves, J. et al.: Analysis of the acute ophthalmic manifestations of the erythema multiforme / Stevens–Johnson syndrome / Toxic epidermal necrolysis disease spectrum. Ophthalmology, 1995, 102: 1669–1676.
9. Roujeau, J.C., Kelly, J.P., Naldi, L. et al.: Medication use and the risk of Stevens–Johnson syndrome or toxic epidermal necrolysis. N Engl J Med, 1955; 333: 1600–1607.
10. Tan, A.W., Thong, B.Y., Yip, L.W. et al.: High-dose intravenous immunoglobulins in the treatment of toxic epidermal necrolysis: an Asian series. J Dermatol, 2005; 32 (1): 1–6.
11. Wolkenstein, P., Revuz, J.: Toxic epidermal necrolysis. Dermatol Clin, 2000; 18: 485–495.
Štítky
OphthalmologyČlánok vyšiel v časopise
Czech and Slovak Ophthalmology
2011 Číslo 3
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