{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T23:29:34Z","timestamp":1768692574833,"version":"3.49.0"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,2,14]],"date-time":"2014-02-14T00:00:00Z","timestamp":1392336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Drugs are by far the most common cause of toxic epidermal necrolysis (<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>), but unidentified drugs and chemicals present in herbal and traditional medications may also be responsible for this reaction, which manifests as widespread epidermal detachment of the skin and mucous membrane. In contexts in which a subject has used an herbal or traditional medication, it is very difficult to diagnose the condition, identify the offending agent, and prevent the disease from recurring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study was conducted at a tertiary burn center between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>uly 2004 and <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ctober 2012. All patients were referred to this unit by the local department of medicine at least one\u00a0week after the eruption of vesicles. On arrival, all patients demonstrated a severe form of disease with features of sepsis and electrolyte imbalance (<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content> scores of \u22654). All non\u2010fatal cases were followed to observe long\u2010term sequelae and recurrences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 34% of patients had developed the condition after ingesting traditional herbal medications and were unable to identify the responsible drug by name. Nineteen (66%) of the 29 patients referred to the unit with <jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content> died within the first week after being transferred. Nine patients achieved complete recovery, and one developed corneal haziness and alopecia. One patient experienced recurrence within three\u00a0months but recovered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Illiteracy and financial vulnerability were major factors in driving patients towards the use of traditional medications, which were often prepared and preserved improperly. Mortality and other complications could be reduced by the prompt recognition of the condition, immediate withdrawal of the culprit drug, and quick referral to proper care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.12253","type":"journal-article","created":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T04:27:21Z","timestamp":1392611241000},"page":"510-515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Unidentified drugs in traditional medications causing toxic epidermal necrolysis: a developing country experience"],"prefix":"10.1111","volume":"53","author":[{"given":"Kishore Kumar","family":"Das","sequence":"first","affiliation":[{"name":"Burns and Plastic Surgery Unit Dhaka Medical College Hospital Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sazzad","family":"Khondokar","sequence":"additional","affiliation":[{"name":"Burns and Plastic Surgery Unit Dhaka Medical College Hospital Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashrafur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Burns and Plastic Surgery Unit Dhaka Medical College Hospital Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjana","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Burns and Plastic Surgery Unit Dhaka Medical College Hospital Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,2,14]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-5-39"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.2217\/pgs.10.77"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.2217\/14622416.9.10.1543"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdl089"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1956.tb12766.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.4076\/1757-1626-2-7765"},{"key":"e_1_2_5_8_1","first-page":"30","article-title":"Does hypernatremia impact mortality in toxic epidermal necrolysis?","volume":"8","author":"Namdar T","year":"2010","journal-title":"Ger Med Sci"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000337755"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000313866"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijd.12253","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.12253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T16:27:02Z","timestamp":1696350422000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.12253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,14]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1111\/ijd.12253"],"URL":"https:\/\/doi.org\/10.1111\/ijd.12253","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,14]]},"assertion":[{"value":"2014-02-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}