The outer, protective, nonvascular layer of the skin of vertebrates, covering the dermis. Nekrolisis epidermal toksik merupakan varian yang paling berat dari penyakit bulosa sepertieritema multiforme dan sindrom stevensjohnson. Hiper ige dengan nekrolisis epidermal toksik ramdhany jurnal. Download asuhan keperawatan dengan nekrolisis epidermal toksik. Both typically occur when the skin and mucous membranes react to a medication, or to a preexisting bacterial infection or illness. Epidermal necrosis is an important finding in dermatopathology. Penyakit dermatology diperantarai imun dermatitis allergy. Among the various drug induced dermatological entities toxic epidermal necrolysis and stevensjohnsons syndrome occupy a primary place in terms of mortality. Tukenmez g, mansur at, tutuncu d, serdar za, aydngoz e. Toxic epidermal necrolysis is a lifethreatening adverse drug reaction involving widespread keratinocyte apoptosis. Prompt withdrawal of the culprit drug is the cornerstone of management including. Toksik epidermal nekrolizis toxic epidermal necrolysis toxic epidermal necrolysis. Semua kelainan tersebut memberikangambaran lesi kulit yang menyebar luas, dan terutama pada badan dan wajah yang melibatkansatu atau lebih membran mukosa.
Toxic epidermal necrolysis definition of toxic epidermal. Allopurinol, aromatic anticonvulsants, antibiotics, lamotrigine and oxicam nsaids. Stevensjohnson syndrome and toxic epidermal necrolysis are two forms of the same lifethreatening skin disease that cause rash, skin peeling, and sores on the mucous membranes. The pathophysiology of toxic epidermal necrolysis is incompletely understood. Toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis, the skins outermost layer, to detach from the layers of skin below. Prompt recognition of these conditions, immediate drug withdrawal and institution of appropriate treatment plays a vital role in reducing mortality. May 20, 2016 toxic epidermal necrolysis ten is a rare, lifethreatening druginduced skin disease with a mortality rate of approximately 30%. Toxic epidermal necrolysis ten is a rare but lifethreatening disease characterized by extensive detachment of the epidermis and mucous membrane erosions. There are several different types of epidermal nevi, including keratinocyte epidermal nevi, nevus sebaceous, nevus comedonicus, and becker nevus. Retrospektif bir degerlendirme ozlem dicle, ertan y. Stevensjohnson syndrome sjs atau sindrom stevensjohnson dan toxic epidermal necrolysis ten atau nekrolisis epidermal toksik adalah penyakit kulit. Keadaan umum pasien membaik dalam 2 minggu setelah dilakukan penghentian obat yang diduga penyebab, penanganan suportif, dan pengobatan spesifik. Kegawatdaruratan dalam bidang dermatologi free download pdf.
Ten is usually caused by new medicines that you started to take within the past 3 weeks. Feb 03, 2020 toxic epidermal necrolysis ten is a rare skin condition that causes you to lose your outer layer of skin. Stevensjohnson syndrome sjs and toxic epidermal necrolysisten. Tesis magister 2019 hubungan pemberian kortikosterioid sistemik dengan prognosis pasien sindrom stevenjohnson dan nekrolisis epidermal toksik di. Sindrom stevensjohnson dan nekrolisis epidermal toksik. Net umumnya merupakan penyakit yang berat, lebih berat daripada ssj, sehingga jika pengobatannya tidak cepat dan tepat sering menyebabkan kematian. Mucous membranes, such as the mouth, are also typically. Eritema multiforme nekrolisis epidermal toksik ten porfiria kutanea tarda pkt. To most physicians, ten represents the most severe form in the broad spectrum of erythema multiforme em, the other forms being erythema multiforme minor and erythema multiforme major or.
Universitas sumatera utara repositori institusi usu departemen dermatologi dan venereologi tesis magister 2019 hubungan pemberian kortikosterioid sistemik dengan prognosis pasien sindrom stevenjohnson dan nekrolisis epidermal toksik di rsup haji adam malik usman, nuri universitas sumatera utara downloaded from repositori institusi usu, univsersitas sumatera utara. Toxic epidermal necrolysis usually begins with flulike prodrome, with a highgrade fever, sorethroat, cough, runny nose, redness of eyes, decreased appetite, malaise, arthralgia, myalgia, and generalized body aches. Mengetahui prognosis atau jumlah kesembuhan pasien sindrom steven johnson dan atau nekrolisis epidermal toksik yang diterapi dengan kortikosteroid sistemik. Toxic epidermal necrolysis ten, or lyell syndrome, is a rare and lifethreatening severe systemic condition associated with dramatic cutaneous sloughing of up to 100% of the body surface area. Epidermal necrolysis definition of epidermal necrolysis. Although it is recognized that ten can occur following sjs, unlike in the rest of the world, there is no sjsten overlap, where epidermal necrolysis occurs in 1030% of the bsa. Toxic epidermal necrolysis an investigation to dye for.
The onset is usually triggered by infections of the upper respiratory tract or by preceding medication, among which nonsteroidal antiinflammatory agents. Mar 24, 2020 download asuhan keperawatan dengan nekrolisis epidermal toksik. Toxic epidermal necrolysis syndrome definition of toxic. Management of stevenjohnson syndrome and toxic epidermal. Asuhan keperawatan pasien dengan syndrom steven johnson download as word doc. This is usually followed by drug exposure on average 14 days prior to the onset of symptoms. Nekrolisis epidermal toksik lebih parah daripada sindrom stevensjohnson sehingga kortikosteroid lebih tinggi, umumnya deksametason 40 mg sehari iv dosis terbagi. Here are links to possibly useful sources of information about toxic epidermal necrolysis. Nekrolisis epidermal toksik sindrom lylle ialah penyakit berat, gejala kulit yang terpenting ialah epidermolisis generalisata, dapat disertai kelainan pada selaput lender di orifisium dan mata. These early lesions, typically found on the head, neck, and upper chest, soon merge and blister.
The hallmark of ten is widespread epidermal sloughing due to keratinocyte apoptosis. Nekrolisis epidermal toksik ten dan sindroma stevensjohnson ssj adalah reaksi akut dari suatu pengobatan yang ditandai dengan kematian dan pengelupasan kulit di bagian epidermis. No large scale epidemiological data are available for this disorder in india. Stevensjohnson syndrome sjs and toxic epidermal necrolysis ten are rare severe cutaneous drug reactions. Sep, 2016 stevensjohnson syndrome sjs and toxic epidermal necrolysis ten or brocqlyell syndrome are dermatoses triggered principally by drugs. The pathogeneses of sjs and ten are unclear, although there is. Stevensjohnson sendromu sjs ve toksik epidermal nekroliz ten deri ve mukozalar. Sp jan 2016 free download as powerpoint presentation.
Toxic epidermal necrolysis ten is a potentially lifethreatening dermatologic disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis andor death see the image below. The exact pathogenic mechanism of ten is still uncertain. Fullthickness necrosis, especially is very serious. Toxic epidermal necrolysis and stevensjohnson syndrome are acute inflammatory skin reactions. Toxic epidermal necrolysis ten is a severe cutaneous drug reaction with a mortality rate of approximately 30%.
Sindrom stevensjohnson sjs adalah sindroma akibat reaksi obat gawat yang mengenai kulit, selaput lendir, dan mata berupa lesi target dengan bentuk tidak teratur, disertai macula, vesikel, bula dan purpura tersebar luas. The incidence of ten is two cases per million personyears. Mar 10, 2020 all materials on our website are shared by users. There is then an abrupt onset of redpurple, dusky, flat spots known as. However, most cases in the pediatric population are not related to recurrences secondary to drug intake. Together with stevensjohnson syndrome sjs it forms a spectrum of disease, with ten being more severe. Ssj merupakan bentuk minor dari toxic epidermal necrolysis ten dengan pengelupasan kulit kurang dari 10% luas permukaan tubuh. Request pdf satu kasus nekrolisis epidermal toksik yang diduga disebabkan oleh kotrimoksasol toxic epidermal necrolysis ten is an acute lifethreatening. Toxic epidermal necrolysis ten is a rare, lifethreatening druginduced skin disease with a mortality rate of approximately 30%. Published on sep askep sindrom steven johnsondocuments. Satu kasus nekrolisis epidermal toksik yang diduga disebabkan. Stevenjohnson sendromu ve toksik epidermal nekroliz.
Pdf asuhan keperawatan dengan nekrolisis epidermal toksik. Widespread fullthickness epidermal necrosis develops, producing erythema, and sloughing of the skin and mucosa, involving internal and external surfaces. Toksik epidermalnekrolizde ntravenoz immunglobulin. Two cases associated to allopurinol and cotrimoxazole. Cases reported as recurrent have been attributed to infectious or environmental factors. Stevensjohnson syndrome sjs and toxic epidermal necrolysis. Mucous membrane involvement can result in gastrointestinal hemor. This article highlights the varied clinical and histologic features of epidermal nevi, discusses recent data on pathogenesis, and provides an update on treatment options. A few days later the skin begins to blister and peel forming painful raw areas. Management of stevenjohnson syndrome and toxic epidermal necrolysis article pdf available in current allergy and clinical immunology 203.
Recurrent stevensjohnson syndrometoxic epidermal necrolysis case reports casselman et al. Toxic epidermal necrolysis ten management ahmed abdulghany 2. Stevensjohnson syndrome and toxic epidermal necrolysis scielo. Recognise toxic epidermal necrolysis and its causes. Stevensjohnson syndrometoxic epidermal necrolysis sjsten is a severe skin reaction most often triggered by particular medications. An integument or outer layer of various invertebrates. Review article toxic epidermal necrolysis management.
Jun 16, 2018 kegawatdaruratandalam bidang dermatologi yuli kurniawati 1 tujuan pembelajaran mengetahui mengenai penyakit kedaruratan dalam dermatologi mampu melakukan penanganan dan melakukan rujukan pada kasus kedaruratan dalam dermatologi 2 pendahuluan kegawatdaruratan dalam dermatologi. Toxic epidermal necrolysis and stevensjohnson syndrome. Nekrolisis epidermal toksik lppmunila institutional repository. Allopurinol, aromatic anticonvulsants, antibiotics, lamotrigine and oxicam nsaids 3. Pdf asuhan keperawatan sindrom steven johnson lailul. Toxic epidermal necrolysis is a dangerous druginduced skin lesion characterized by extensive, mucocutaneous blistering. Nekrolisis epidermal toksik net merupakan reaksi mukokutan akut yang mengancam jiwa, ditandai nekrosis dan pelepasan. See also introduction to hypersensitivity reactions and inflammatory skin disorders. Toxic epidermal necrolysis ten is a type of severe skin reaction.
Semua kelainan tersebut memberikan gambaran lesi kulit yang menyebar luas, dan terutama pada badan dan wajah yang melibatkan satu atau lebih membran mukosa. Oct 24, 2016 sindrom stevensjohnson ssj merupakan sindrom yang mengenai kulit, selaput lendir di orifisium, dan mata dengan keadaan umum yang bervariasi dari ringan hingga berat. Akdeniz universitesi tp fakultesi, deri ve zuhrevi hastalklar anabilim dal, antalya, turkiye 180. We describe two cases of druginduced toxic epidermal necrolysis, a male and a female, both caucasoids of pakistani origin, one treated without any steroids and the other with them, who made complete recovery without any major complications or sequelae. Stevensjohnson sendromu ve toksik epidermal nekroliz. Toxic epidermal necrolysis ten is a rare, lifethreatening. Case report of geriatric patient abstract toxic epidermal necrolysis ten is an acute mucocutaneous reaction characterized by necrosis and more than 30% epidermolysis of body surface areas, accompanied by pain and can cause death. Bila setelah dua hari diobati dengan cara tersebut, masih juga timbul lesi baru hendaknya dipikirkan kemungkinana alergi terhadap obat yang diberikan pada waktu rawat inap.
Both typically occur when the skin and mucous membranes react to a medication, or to a. Management of stevenjohnson syndrome and toxic epidermal necrolysis. Toksik epidermal nekrolizis toxic epidermal necrolysis 2 introduction stevensjohnson syndrome sjs and toxic epidermal necrolysis ten are acute and severe reactions of the skin and mucosa that can lead to serious clinical outcomes and morbidity. Sheets of epidermis then begin to detach from the skin layers below. Toxic epidermal necrolysis ten is an acute lifethreatening mucocutaneous reaction, characterized by. Pdf management of stevenjohnson syndrome and toxic. Stevensjohnson syndrome toxic epidermal necrolysis.
Nekrolisis epidermal toksik adalah bentuk sindrom steven johnson yang lebih berat dengan kelainan kulit yang memerlukan penanganan segera yang paling banyak disebabkan oleh obatobatan. Pdf asuhan keperawatan dengan nekrolisis epidermal. Satu kasus nekrolisis epidermal toksik yang diduga. Penyakit dermatology diperantarai imun free download as powerpoint presentation. Pendahuluan nekrolisis epidermal toksik pertama kali dideskripsikan oleh alan lylle. Hiper ige hies disebut juga sindroma ayub adalah gangguan. Dec 20, 2018 toxic epidermal necrolysis ten is a potentially lifethreatening dermatologic disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis andor death see the image below. Although stevensjohnson syndrome and toxic epidermal necrolysis were once thought to be separate conditions, they are now considered part of a continuum. Pdf stevensjohnson syndrome sjs and toxic epidermal necrolysisten represent a spectrum of the same disease. Toksik epidermalnekrolizde ntravenoz immunglobulin tedavisi. One of the most severe cutaneous reactions to drug therapy is toxic epidermal necrolysis ten, a rare disease that results in skin eruptions resembling burns and is characterized by extensive. In japan, ten is characterized by an epidermal necrolysis greater than 10% of the bsa. Terdiri dari konsep dasar penyakit sindrom steven johnson dan konsep asuhan keperawatan pada klien dengan sindrom steven johnson.
Stevenjohnson sendromu ve toksik epidermal nekroliz stevenjohnson syndrome sjs and toxic epidermal necrolysis erkan alpsoy, ozlem dicle, ay. Then the skin changes begin, with a flat red rash on the face, neck, and trunk, often. Satu kasus nekrolisis epidermal toksik yang diduga disebabkan oleh kotrimoksasol. Stevensjohnson syndrome toxic epidermal necrolysis defined. Addthis askep sindrom steven johnson documents view more. It may be caused by drug reactions, infections viral, bacterial, or fungal, neoplastic disease, graftversushost reaction, and chemical exposure.
Meskipun begitu, etiologi lainnya, termasuk infeksi, keganasan, dan vaksinasi, juga bisa menyebabkan penyakit ini. Sebagian besar penulis dan ahli berpendapat bahwa sindrom stevensjohnson dan nekrolisis epidermal toksik net merupakan penyakit yang sama dengan manifestasi yang berbeda. Stevensjohnson syndrome and toxic epidermal necrolysis. The clinical hallmark of ten is a marked skin detachment caused by extensive keratinocyte cell death associated with mucosal involvement. Toxic epidermal necrolysis ten and stevenjohnson syndrome sjs are characterized by extensive necrosis and cleavage of the epidermis from the dermis akin to a superficial or partial thickness burn. Sepsis is the usual cause of mortality but much of the pathophysiologic process results from an outpouring of cytokines and matrixmetal. Nekrolisis epidermal sindroma steven johnson ssj, toksik epidermal nekrolisis ten, ssj ten overlap erupsi. Toxic epidermal necrolysis ten begins with fever, cough, and other nonspecific symptoms, and is soon followed by purplish, bloodylooking lesions on the skin and mucous membranes. The onset is usually triggered by infections of the upper respiratory tract or by preceding medication, among which nonsteroidal anti.
Ideal sources for wikipedia s health content are defined in the guideline wikipedia. Sepsis is the usual cause of mortality but much of. Nekrolisis epidermal toksik merupakan varian yang paling berat dari penyakit bulosa seperti eritema multiforme dan sindrom stevensjohnson. Another more severe form of the disease is called toxic epidermal necrolysis. Tatalaksana pasien ssj dan net yang tepat memberikan kesembuhan sempurna. Stevensjohnson syndrome is a rare, potentially lethal disease that attacks the skin. Mucous membrane involvement can result in gastrointestinal. Kegawatdaruratan dalam bidang dermatologi free download. Toxic epidermal necrolysis, skin detachment, keratinocyte cell. Aug 22, 2014 toxic epidermal necrolysis ten is an acuteonset, potentially lifethreatening, idiosyncratic mucocutaneous reaction, usually occurring after commencement of a new medication. The most common medicines include antibiotics, seizure. Stevensjohnson syndrome and toxic epidermal necrolysis usually begin 1 to 3 weeks after the start of a drug if caused by a drug with fever, headache, cough, keratoconjunctivitis inflammation of the conjunctiva and the cornea in the eyes, and body aches.
Sindroma ini termasuk jenis hipersensitif tipe iii dan iv. Adverse drug effects occur frequently enough to be a public health concern. Nekrolisis epidermal toksik net merupakan reaksi mukokutan. Asuhan keperawatan pada klien penderita sindrom steven johnson ssj.