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Dermatological Disorders | ||||
| Dermatological disorders and Mycoplasma infectious diseases | |||||
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Stevens-Johnson syndromeStevens–Johnson syndrome, a form of toxic epidermal necrolysis, is a life-threatening skin condition, in which cell death causes the epidermis to separate from the dermis.Stevens–Johnson syndrome (SJS) is a milder form of toxic epidermal necrolysis (TEN). The distinction between SJS, SJS/TEN overlap, and TEN is based on the type of lesions and the amount of the body surface area with blisters and erosions. Erythema multiforme, which is also within a spectrum, differs in clinical pattern and etiology. Although both SJS and TEN can also be caused by infections, they are most often adverse effects of medications. SJS usually begins with fever, sore throat, and fatigue. SJS is thought to arise from a disorder of the immune system. The immune reaction can be triggered by drugs or infections. Also, SJS may be caused by adverse effects of the drugs. Ulcers and other lesions begin to appear in the mucous membranes, almost always in the mouth and lips, but also in the genital and anal regions. Conjunctivitis of the eyes occurs in about 30% of children who develop SJS. The second most common cause of SJS and TEN is infection, particularly in children. This includes upper respiratory infections, otitis media, pharyngitis, and Epstein-Barr virus, Mycoplasma pneumoniae and cytomegalovirus infections. The routine use of medicines such as antibiotics, antipyretics and analgesics to manage infections can make it difficult to identify if cases were caused by the infection or medicines taken. SJS constitutes a dermatological emergency. Patients with documented Mycoplasma infections can be treated with oral macrolide or oral doxycycline. Treatment with corticosteroids is controversial. Early retrospective studies suggested corticosteroids increased hospital stays and complication rates. Stevens-Johnson syndrome and Mycoplasma Infectious Diseases (MID Erythema multiforme due to Mycoplasma pneumoniae infection in two children. (2006) http://www.ncbi.nlm.nih.gov/pubmed/17155996 Stevens-Johnson syndrome due to Mycoplasma pneumoniae in an adult.(1985) http://www.ncbi.nlm.nih.gov/pubmed/4050840 Stevens-Johnson syndrome associated with Mycoplasma pneumoniae infections.(1978) http://www.ncbi.nlm.nih.gov/pubmed/629550 Allergy・ J.S. Seggev, G.V. Sedmak, V.P. Kurup, Isotype-specific antibody responses to acute Mycoplasma pneumoniae infection, Ann Allergy Asthma Immunol 77 (1996) 67-73. Bullous erythema multiforme・ P.C. Schalock, J.B. Brennick, J.G. Dinulos, Mycoplasma pneumoniae infection associated with bullous erythema multiforme, J Am Acad Dermatol 52 (2005) 705-706.Gianotti-Crosti syndrome・S. Manoharan, J. Muir, R. Williamson, Gianotti-Crosti syndrome in an adult following recent Mycoplasma pneumoniae infection, Australas J Dermatol 46 (2005) 106-109.Adamantiades-Behcet's diseaseZouboulis CC, May T, Pathogenesis of Adamantiades-Behcet's disease, Med Microbiol Immunol (Berl) 192 (2003) 149-155.Zouboulis CC, Turnbull JR, Mühlradt PF. (2003) Association of Mycoplasma fermentans with Adamantiades-Behçet's disease. Adv Exp Med Biol. 528:191-194. Zouboulis CC, Turnbull JR, Mühlradt PF. (2003) High seroprevalence of anti-Mycoplasma fermentans antibodies in patients with malignant aphthosis. J Invest Dermatol. 121:211-212. |
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