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Plasmapheresis in toxic epidermal necrolysis
G C Chaidemenos1, F Chrysomallis, K Sombolos
1State Hospital for Skin and Veneral Diseases, Department of Dermatology, Aristotle University of Thessaloniki, Greece.
International Journal of Dermatology
|March 1, 1997
Summary
Plasma exchange (PE) is a safe and effective treatment for toxic epidermal necrolysis (TEN), significantly improving patient recovery. Alternate-day PE is recommended over daily sessions for optimal outcomes in severe TEN cases.
Area of Science:
- Dermatology
- Intensive Care Medicine
- Immunology
Background:
- Toxic epidermal necrolysis (TEN) is a severe, life-threatening skin reaction with high mortality.
- Current treatments like drug withdrawal and supportive care have limited efficacy.
- Biologic dressings and plasma exchange (PE) have shown potential in specialized centers.
Purpose of the Study:
- To evaluate the efficacy and safety of plasma exchange (PE) as a primary treatment for severe toxic epidermal necrolysis (TEN).
Main Methods:
- An open study included seven patients with severe TEN (30-80% body surface area, 2-4 mucous membranes involved).
- Potential causative agents included malignancies and various medications.
- Patients received one to four plasma exchange (PE) sessions of 2.5 L, either daily or on alternate days.
Main Results:
- All seven patients successfully recovered from TEN without new lesions after the first PE in four cases.
- No adverse reactions or long-term sequelae related to PE were observed during follow-up up to 8 years.
Conclusions:
- Plasma exchange (PE) is a safe and effective first-line therapy for toxic epidermal necrolysis (TEN), offering rapid symptom relief.
- Despite cost and access considerations, PE can significantly reduce TEN mortality.
- Alternate-day PE appears more beneficial than daily sessions.