Oropharyngolaryngeal manifestations in severe toxic epidermal necrolysis: a single-center's retrospective case series.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_9BEFA3B2A5DC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Oropharyngolaryngeal manifestations in severe toxic epidermal necrolysis: a single-center's retrospective case series.
Journal
International journal of dermatology
Author(s)
Glasson N., De Sandre C., Pantet O., Reinhard A., Lambercy K., Sandu K., Gorostidi F.
ISSN
1365-4632 (Electronic)
ISSN-L
0011-9059
Publication state
Published
Issued date
11/2023
Peer-reviewed
Oui
Volume
62
Number
11
Pages
1384-1390
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Toxic epidermal necrolysis is a rare and life-threatening mucocutaneous disease. Although mucosal ear, nose, and throat (ENT) involvement is common, little is known about the characteristics, treatment modalities, and outcomes of these lesions. The aim of this study was to evaluate ENT mucosal lesions in severe toxic epidermal necrolysis patients and analyze their characteristics, treatment modalities, and outcomes, as well as proposing a management algorithm to prevent long-term debilitating sequalae of these lesions.
This is a retrospective review of toxic epidermal necrolysis cases treated at the tertiary burns unit of the Lausanne University Hospital CHUV, Switzerland, between 2006 and 2019.
Out of 19 patients with severe toxic epidermal necrolysis, 17 (89%) underwent a complete ENT examination at admission and 14 (82%) had ENT mucosal involvement. Five (26.3%) patients died during the stay in the intensive care unit. Of the 16 patients who received maximal care, 13 (81%) required orotracheal intubation for a median time of 16 (IQR: 14) days. Out of the 14 patients who survived, four (29%) had long-term ENT complications consisting of synechiaes necessitating subsequent endoscopic procedures. Those four patients all required mechanical ventilation with an orotracheal tube and suffered from hypopharyngeal synechiaes as well as oral and endonasal synechiaes in individual cases.
This study suggests a high prevalence of ENT synechiaes in patients with severe toxic epidermal necrolysis and requiring orotracheal intubation. Periodic ENT examination could prevent mature synechiae formation in these patients. We propose an algorithm to prevent long-term sequalae in ENT mucosal involvement.
Pubmed
Web of science
Open Access
Yes
Create date
02/10/2023 15:37
Last modification date
10/02/2024 8:25
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