{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T03:20:29Z","timestamp":1761016829418,"version":"3.37.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2009,10,22]],"date-time":"2009-10-22T00:00:00Z","timestamp":1256169600000},"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":[[2009,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold>The severe adverse cutaneous reactions of erythema multiforme (EM), Stevens\u2013Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare mucocutaneous diseases associated with significant morbidity and mortality. The most common cause is antiepileptic drugs, particularly carbamazepine and lamotrigine, as well as the barbiturates group (phenobarbital and phenytoin). In this article, we present seven children with severe adverse cutaneous reactions caused by barbiturates.<\/jats:p><jats:p><jats:bold>Case Reports\u2002<\/jats:bold>The age of the affected children was between 2 and 11\u00a0years and they all had a history of taking barbiturates. Their symptoms started 1\u20133\u00a0weeks after the initiation of barbiturates, including a prodrome characterized by 2\u20133\u00a0days of malaise, fever, cough and anorexia, after which the skin and mucosal lesions appeared and worsened. The skin lesions varied from rash to large bullae, plus different forms of mucous membrane involvement. The offending drugs (barbiturates) were stopped immediately and care was largely supportive.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold>As a result of the morbidity and\/or mortality associated with EM, SJS and TEN, physicians should keep in mind their differential diagnosis when cutaneous reactions are observed in patients undergoing barbiturate therapy. Furthermore, although TEN and SJS are life\u2010threatening diseases, early detection and appropriate care can lead to a decrease in the incidence of death. The strategies described here seem to be successful and safe because, despite the serious conditions, our patients responded well. All survived.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2007.03561.x","type":"journal-article","created":{"date-parts":[[2009,10,22]],"date-time":"2009-10-22T10:08:11Z","timestamp":1256206091000},"page":"1254-1261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Severe cutaneous reactions caused by barbiturates in seven Iranian children"],"prefix":"10.1111","volume":"48","author":[{"given":"Setareh","family":"Mamishi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Fattahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Pourpak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzaneh Mirza","family":"Aghaee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeinab","family":"Moinfar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Ashrafi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Moin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,10,22]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200225130-00006"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1990.01670250049006"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11369-1"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000156354.20227.F0"},{"key":"e_1_2_5_6_2","first-page":"125","article-title":"Cotrimoxazole induced toxic epidermal necrolysis in a suspected case of Pneumocystis carinii pneumonia with human immunodeficiency virus infection","volume":"40","author":"Arora VK","year":"1998","journal-title":"Indian J Chest Dis Allied Sci"},{"key":"e_1_2_5_7_2","first-page":"116","article-title":"Toxic epidermal necrolysis","volume":"41","author":"Cohen V","year":"2002","journal-title":"Int J Dermatol"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2005.22407.x"},{"key":"e_1_2_5_9_2","first-page":"17","article-title":"Treatment of toxic epidermal necrolysis (TEN)","volume":"15","author":"Brambilla G","year":"2002","journal-title":"Ann Burns Fire Disasters"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.5.1162"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10227-001-0012-2"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1996.tb00032.x"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0091270005281205"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-4274(01)00506-9"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2000.04.1015"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(08)81995-0"},{"key":"e_1_2_5_17_2","first-page":"A85","article-title":"Adverse cutaneous reactions to drugs in hospitalized children in a Department of Infectious Disease","volume":"125","author":"Fattahi F","year":"2005","journal-title":"J Invest Dermatol"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:NEON.0000014538.31561.bc"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332404"},{"key":"e_1_2_5_20_2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0031-6997(24)01501-1","article-title":"Cutaneous drug reactions","volume":"53","author":"Svensson CK","year":"2001","journal-title":"Pharmacol Rev"},{"key":"e_1_2_5_21_2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4037\/ccn1997.17.6.47","article-title":"Toxic epidermal necrolysis: a critical care challenge","volume":"17","author":"Supple KG","year":"1997","journal-title":"Crit Care Nurse"},{"key":"e_1_2_5_22_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5070\/D397D8T291","article-title":"Treatment of severe drug reactions: Stevens\u2013Johnson syndrome, toxic epidermal necrolysis and hypersensitivity syndrome","volume":"8","author":"Ghislain PD","year":"2002","journal-title":"Dermatol Online J"},{"key":"e_1_2_5_23_2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1001\/archderm.1990.01670250043005","article-title":"Toxic epidermal necrolysis (Lyell syndrome). 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