Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications

In 2005, the “Japanese Research Committee on Severe Cutaneous Adverse Reaction” (J-SCAR) presented the official “Diagnostic Criteria” for SJS/TEN, and the specific ocular findings are included in these very important criteria. In SJS/TEN cases involving ocular disorder, conjunctivitis often occurs p...

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Published in:Frontiers in Medicine
Main Authors: Sotozono, Chie, Ueta, Mayumi, Kinoshita, Shigeru
Format: Article in Journal/Newspaper
Language:unknown
Published: Frontiers Media SA 2021
Subjects:
Online Access:http://dx.doi.org/10.3389/fmed.2021.657327
https://www.frontiersin.org/articles/10.3389/fmed.2021.657327/full
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spelling crfrontiers:10.3389/fmed.2021.657327 2024-02-11T10:08:24+01:00 Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications Sotozono, Chie Ueta, Mayumi Kinoshita, Shigeru 2021 http://dx.doi.org/10.3389/fmed.2021.657327 https://www.frontiersin.org/articles/10.3389/fmed.2021.657327/full unknown Frontiers Media SA https://creativecommons.org/licenses/by/4.0/ Frontiers in Medicine volume 8 ISSN 2296-858X General Medicine journal-article 2021 crfrontiers https://doi.org/10.3389/fmed.2021.657327 2024-01-26T10:02:57Z In 2005, the “Japanese Research Committee on Severe Cutaneous Adverse Reaction” (J-SCAR) presented the official “Diagnostic Criteria” for SJS/TEN, and the specific ocular findings are included in these very important criteria. In SJS/TEN cases involving ocular disorder, conjunctivitis often occurs prior to the onset of the high fever. In a Japanese survey, ocular involvement was observed in 77% of the cases, and the incidence of ocular sequelae increased depending on the score of the acute ocular severity findings. Pseudo-membrane formation and epithelial defects are considered to be high-risk signs of ocular sequelae. At the chronic stage, limbal stem cell deficiency, visual disturbance, and severe dryness of the ocular surface are the primary disease characteristics. In 2002, we started performing Cultivated Oral Mucosal Epithelial Transplantation (COMET) for the treatment of severe ocular disorders, including SJS/TEN. As an additional treatment method, we developed a new type of rigid contact lens (CL) that is 13 to 14.0-mm in diameter, known as the “Limbal Rigid Contact Lens (Limbal CL).” Our Limbal Rigid CL greatly enhances the postoperative outcome of COMET. The detection rate of ocular surface bacteria is high in SJS/TEN cases. Thus, appropriate use of topical antibiotics reduces the risk of ocular surface inflammation. Moreover, rebamipide is an ophthalmic solution for dry eye that was developed in Japan, and it also has the effect of suppressing ocular surface inflammation. From disease onset until the chronic stage, the control of inflammation and stem cell loss is key to successfully treating eyes afflicted with SJS/TEN. Article in Journal/Newspaper SCAR Frontiers (Publisher) Frontiers in Medicine 8
institution Open Polar
collection Frontiers (Publisher)
op_collection_id crfrontiers
language unknown
topic General Medicine
spellingShingle General Medicine
Sotozono, Chie
Ueta, Mayumi
Kinoshita, Shigeru
Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications
topic_facet General Medicine
description In 2005, the “Japanese Research Committee on Severe Cutaneous Adverse Reaction” (J-SCAR) presented the official “Diagnostic Criteria” for SJS/TEN, and the specific ocular findings are included in these very important criteria. In SJS/TEN cases involving ocular disorder, conjunctivitis often occurs prior to the onset of the high fever. In a Japanese survey, ocular involvement was observed in 77% of the cases, and the incidence of ocular sequelae increased depending on the score of the acute ocular severity findings. Pseudo-membrane formation and epithelial defects are considered to be high-risk signs of ocular sequelae. At the chronic stage, limbal stem cell deficiency, visual disturbance, and severe dryness of the ocular surface are the primary disease characteristics. In 2002, we started performing Cultivated Oral Mucosal Epithelial Transplantation (COMET) for the treatment of severe ocular disorders, including SJS/TEN. As an additional treatment method, we developed a new type of rigid contact lens (CL) that is 13 to 14.0-mm in diameter, known as the “Limbal Rigid Contact Lens (Limbal CL).” Our Limbal Rigid CL greatly enhances the postoperative outcome of COMET. The detection rate of ocular surface bacteria is high in SJS/TEN cases. Thus, appropriate use of topical antibiotics reduces the risk of ocular surface inflammation. Moreover, rebamipide is an ophthalmic solution for dry eye that was developed in Japan, and it also has the effect of suppressing ocular surface inflammation. From disease onset until the chronic stage, the control of inflammation and stem cell loss is key to successfully treating eyes afflicted with SJS/TEN.
format Article in Journal/Newspaper
author Sotozono, Chie
Ueta, Mayumi
Kinoshita, Shigeru
author_facet Sotozono, Chie
Ueta, Mayumi
Kinoshita, Shigeru
author_sort Sotozono, Chie
title Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications
title_short Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications
title_full Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications
title_fullStr Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications
title_full_unstemmed Japan: Diagnosis and Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications
title_sort japan: diagnosis and management of stevens-johnson syndrome/toxic epidermal necrolysis with severe ocular complications
publisher Frontiers Media SA
publishDate 2021
url http://dx.doi.org/10.3389/fmed.2021.657327
https://www.frontiersin.org/articles/10.3389/fmed.2021.657327/full
genre SCAR
genre_facet SCAR
op_source Frontiers in Medicine
volume 8
ISSN 2296-858X
op_rights https://creativecommons.org/licenses/by/4.0/
op_doi https://doi.org/10.3389/fmed.2021.657327
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