{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:54:32Z","timestamp":1792029272077,"version":"4.4.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Toxic epidermal necrolysis like lupus erythematosus (TEN-like LE) is a dermatological emergency associated with significant morbidity and mortality. It requires prompt recognition and differentiation from its mimics including drug induced toxic epidermal necrolysis, erythema multiforme, drug rash with eosinophilia and systemic symptoms, and reactive infectious mucocutaneous eruptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess systemically the clinical, pathological, and immunological features of patients with TEN-like LE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a structured search systematic review from April-May 2024, of studies on TEN-like LE published between 1977 and 2024., searching PubMed, Medline, Embase, SCOPUS, VHL, ProQuest,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      , COCHRANE, POPLINE, ISI, mRCT, UC library, and ResearchGate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There were 16 case series and 52 case reports\/conference papers yielding 112 unique cases. The mean age was 43.39 years, and 86.6% of cases were female. TEN-like LE was the presenting manifestation of lupus erythematosus (LE) in 48.21% of patients. Antinuclear antibody (ANA) was positive in all 109 patients where it was reported with SSA\/Ro being most commonly positive (60.55%), followed by dsDNA (50%). Lesions were reported to be photodistributed in 78.57%, palmoplantar involvement was seen in 20.54%, and mucosal involvement was seen in 56.25%, with 26.78% patients having significant mucosal involvement. Lupus non-specific lesions were observed in 25% patients. Anemia, pulmonary and GI involvement were positively associated with hemodynamic instability, and anti-Ro antibodies were negatively associated. Positive dsDNA, La positivity, and low C4 were associated with increased odds of systemic involvement, whereas Ro positivity was associated with reduced odds. Seven patients had a paraneoplastic association. TEN-like LE can be the first manifestation of LE in up to half of cases. Photodistribution, lupus non-specific lesions, ANA positivity, or change in ANA type\/titre can be important diagnostic clues. Unlike previously believed, mucosal involvement is not uncommon and can be severe.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033251371801","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T07:12:27Z","timestamp":1756192347000},"page":"1221-1229","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical, pathological and immunological features of toxic-epidermal necrolysis like lupus erythematosus: A systematic review and proposal for diagnostic criteria"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1199-8075","authenticated-orcid":false,"given":"Sweta","family":"Subhadarshani","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Griffith","sequence":"additional","affiliation":[{"name":"University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Thornton","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Cincinnati, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nicholas","sequence":"additional","affiliation":[{"name":"University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000000830"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1191\/0961203304lu2037sa"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313492242"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000346"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17753"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.18424"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/IN9.0000000000000004"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10705.x"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17698"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.949520"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.1090"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2008.02704.x"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17122135"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.5070\/D3245040100"},{"issue":"2","key":"e_1_3_5_16_2","first-page":"216","article-title":"Cutaneous lupus erythematosus: clinico-pathologic correlation","volume":"153","author":"Filotico R","year":"2018","unstructured":"Filotico R, Mastrandrea V. Cutaneous lupus erythematosus: clinico-pathologic correlation. G Ital Dermatol Venereol 2018; 153(2): 216\u2013229.","journal-title":"G Ital Dermatol Venereol"},{"key":"e_1_3_5_17_2","first-page":"282","volume-title":"Dubois\u2019 Lupus Erythematosus and Related Syndromes","author":"Riemakasten G","year":"2013","unstructured":"Riemakasten G, Hiepe F. Autoantibodies. In: Wallace DJ, Hahn BH (eds). Dubois\u2019 Lupus Erythematosus and Related Syndromes. 8th ed. 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