{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:00Z","timestamp":1790983080437,"version":"4.1.0"},"reference-count":75,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Toxic epidermal necrolysis (TEN) is a rare, life-threatening mucocutaneous adverse drug reaction associated with extensive epidermal necrosis and severe systemic complications. We report the case of a 25-year-old woman who developed severe lamotrigine-induced TEN four weeks after treatment initiation. The disease rapidly progressed to involve approximately 60% of the body surface area, requiring intensive care unit admission, mechanical ventilation, and multidisciplinary management. Treatment included high-dose intravenous methylprednisolone, intravenous immunoglobulins, etanercept, plasmapheresis, and comprehensive supportive care. During hospitalization, the patient developed gastrointestinal complications manifested by pneumatosis intestinalis and portal venous gas, raising suspicion of bowel ischemia and prompting exploratory laparotomy. Following treatment, gradual clinical improvement and complete resolution of the cutaneous lesions were achieved. However, persistent ocular sequelae developed, including meibomian gland dysfunction, punctate epithelial erosions, conjunctival scarring, trichiasis, tear film instability, and early corneal neovascularization, requiring long-term ophthalmological follow-up. To provide clinical context, a narrative review of the literature on the diagnosis, multidisciplinary management, gastrointestinal manifestations, ocular complications, and systemic treatment of TEN was performed. A comprehensive literature search was conducted to identify relevant articles focusing on the intensive care management and specific organ-related manifestations of Toxic Epidermal Necrolysis (TEN). The gathered literature was narratively synthesized to present a cohesive update on current clinical practices and management controversies. This case highlights the potentially devastating multiorgan course of TEN and emphasizes the importance of early recognition, specialized intensive care, and long-term multidisciplinary follow-up.<\/jats:p>","DOI":"10.3390\/life16081238","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T08:15:56Z","timestamp":1785140156000},"page":"1238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lamotrigine-Induced Toxic Epidermal Necrolysis with Multiorgan Failure, Pneumatosis Intestinalis and Chronic Ocular Complications"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3647-9119","authenticated-orcid":false,"given":"Jakub","family":"Szrama","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Smuszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadeusz","family":"Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8617-2820","authenticated-orcid":false,"given":"Ashish","family":"Lohani","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Zwoli\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Sobczy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"\u0141ab\u0119d\u017a","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Poznan University of Medical Science, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Da\u0144czak-Pazdrowska","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Poznan University of Medical Science, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9288-6257","authenticated-orcid":false,"given":"Pawe\u0142","family":"Pazdrowski","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, 60-780 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Miko\u0142ajczyk-Lorkiewicz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, 60-780 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Wojciechowska","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, 60-780 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9540-9500","authenticated-orcid":false,"given":"Marcin","family":"Stopa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, 60-780 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Pola\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology, Poznan University of Medical Sciences, 60-780 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1089\/wound.2019.0977","article-title":"Toxic Epidermal Necrolysis and Steven-Johnson Syndrome: A Comprehensive Review","volume":"9","author":"Charlton","year":"2020","journal-title":"Adv. Wound Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.jid.2017.01.031","article-title":"The Epidemiology of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the UK","volume":"137","author":"Frey","year":"2017","journal-title":"J. Investig. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Yang, M.S., Lee, J.Y., Kim, J., Kim, G.W., Kim, B.K., Kim, J.Y., Park, H.W., Cho, S.H., Min, K.U., and Kang, H.R. (2016). Incidence of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Nationwide Population-Based Study Using National Health Insurance Database in Korea. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0165933"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1038\/jid.2012.510","article-title":"Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"133","author":"Sekula","year":"2013","journal-title":"J. Investig. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1001\/jamadermatol.2013.4114","article-title":"Relationship between the HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review and meta-analysis","volume":"149","author":"Tangamornsuksan","year":"2013","journal-title":"JAMA Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Somkrua, R., Eickman, E.E., Saokaew, S., Lohitnavy, M., and Chaiyakunapruk, N. (2011). Association of HLA-B*5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: A systematic review and meta-analysis. BMC Med. Genet., 12.","DOI":"10.1186\/1471-2350-12-118"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1016\/j.jid.2016.03.023","article-title":"Morbidity and Mortality of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in United States Adults","volume":"136","author":"Hsu","year":"2016","journal-title":"J. Investig. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/j.1365-2133.2011.10705.x","article-title":"Stevens-Johnson syndrome and toxic epidermal necrolysis in patients with lupus erythematosus: A descriptive study of 17 cases from a national registry and review of the literature","volume":"166","author":"Ziemer","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2165\/11593240-000000000-00000","article-title":"Incidence of toxic epidermal necrolysis and Stevens-Johnson Syndrome in an HIV cohort: An observational, retrospective case series study","volume":"13","author":"Mittmann","year":"2012","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1016\/j.jid.2018.04.027","article-title":"Stevens-Johnson Syndrome\/Toxic Epidermal Necrolysis: A Multicenter Retrospective Study of 377 Adult Patients from the United States","volume":"138","author":"Micheletti","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ajem.2024.04.001","article-title":"High risk and low prevalence diseases: Stevens Johnson syndrome and toxic epidermal necrolysis","volume":"81","author":"Long","year":"2024","journal-title":"Am. J. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jdin.2023.06.014","article-title":"Epidemiology of Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States and factors predictive of outcome","volume":"13","author":"Wasuwanich","year":"2023","journal-title":"JAAD Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.clindermatol.2020.06.016","article-title":"Diagnosis and management of Stevens-Johnson syndrome\/toxic epidermal necrolysis","volume":"38","author":"Noe","year":"2020","journal-title":"Clin. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1097\/ACI.0000000000000180","article-title":"Monitoring the acute response in severe hypersensitivity reactions to drugs","volume":"15","author":"Shiohara","year":"2015","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"194","DOI":"10.3390\/toxins6010194","article-title":"Cytotoxic proteins and therapeutic targets in severe cutaneous adverse reactions","volume":"6","author":"Su","year":"2014","journal-title":"Toxins"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1038\/nm.1884","article-title":"Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"14","author":"Chung","year":"2008","journal-title":"Nat. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1111\/bjd.14530","article-title":"U.K. guidelines for the management of Stevens\u2013Johnson syndrome\/toxic epidermal necrolysis in adults 2016","volume":"174","author":"Creamer","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/00004630-200203000-00004","article-title":"A multicenter review of toxic epidermal necrolysis treated in U.S. burn centers at the end of the twentieth century","volume":"23","author":"Palmieri","year":"2002","journal-title":"J. Burn. Care Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/0003-4819-151-7-200910060-00016","article-title":"Granulysin as a marker for early diagnosis of the Stevens-Johnson syndrome","volume":"151","author":"Abe","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"612","DOI":"10.12688\/f1000research.24748.1","article-title":"Recent advances in managing and understanding Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"9","author":"Hasegawa","year":"2020","journal-title":"F1000Research"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Frantz, R., Huang, S., Are, A., and Motaparthi, K. (2021). Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management. Medicina, 57.","DOI":"10.3390\/medicina57090895"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/j.1468-3083.2012.04502.x","article-title":"SCORTEN and impaired renal function related to mortality of toxic epidermal necrolysis syndrome patients in the Asian population","volume":"27","author":"Hu","year":"2013","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1111\/jdv.16137","article-title":"Accuracy of SCORTEN to predict the prognosis of Stevens-Johnson syndrome\/toxic epidermal necrolysis: A systematic review and meta-analysis","volume":"34","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_24","first-page":"499","article-title":"Toxic epidermal necrolysis: A paradigm of critical illness","volume":"29","author":"Aramburu","year":"2017","journal-title":"Rev. Bras. Ter. Intensiv."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jaad.2014.04.044","article-title":"Entanercept therapy for toxic epidermal necrolysis","volume":"71","author":"Paradisi","year":"2014","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1016\/j.jid.2017.05.022","article-title":"Cyclosporine use in epidermal necrolysis is associated with an important mortality reduction: Evidence from three different approaches","volume":"137","author":"Cachafeiro","year":"2017","journal-title":"J. Investig. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2147\/JIR.S160964","article-title":"A meta-analysis of cyclosporine treatment for Stevens-Johnson syndrome\/toxic epidermal necrolysis","volume":"11","author":"Ng","year":"2018","journal-title":"J. Inflamm. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1001\/jamadermatol.2018.5605","article-title":"Development and Validation of a Risk Prediction Model for In-Hospital Mortality Among Patients With Stevens-Johnson Syndrome\/Toxic Epidermal Necrolysis-ABCD-10","volume":"155","author":"Noe","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_29","first-page":"323","article-title":"Toxic epidermal necrolysis and Stevens-Johnson syndrome: Does early withdrawal of causative drugs decrease the risk of death?","volume":"136","author":"LeCleach","year":"2000","journal-title":"Arch. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s13671-019-00275-0","article-title":"Management of Stevens-Johnson Syndrome\/Toxic Epidermal Necrolysis: A Review and Update","volume":"8","author":"Coias","year":"2019","journal-title":"Curr. Derm. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.survophthal.2016.01.004","article-title":"Stevens-Johnson syndrome: The role of an ophthalmologist","volume":"61","author":"Jain","year":"2016","journal-title":"Surv. Ophthalmol."},{"key":"ref_32","first-page":"81","article-title":"Prevention of vulvovaginal sequelae in stevens-johnson syndrome and toxic epidermal necrolysis","volume":"4","author":"Kaser","year":"2011","journal-title":"Rev. Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.cps.2017.02.016","article-title":"Burn Center Care of Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis","volume":"44","author":"Cartotto","year":"2017","journal-title":"Clin. Plast. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.amjsurg.2015.12.011","article-title":"Indications for intubation and early tracheostomy in patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis","volume":"211","author":"Williams","year":"2016","journal-title":"Am. J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1007\/s12325-017-0530-y","article-title":"Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Concise Review with a Comprehensive Summary of Therapeutic Interventions Emphasizing Supportive Measures","volume":"34","author":"Schneider","year":"2017","journal-title":"Adv. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"230","DOI":"10.5603\/AIT.2013.0044","article-title":"Acid-base disorder analysis during diabetic ketoacidosis using the Stewart approach\u2014A case report","volume":"45","author":"Szrama","year":"2013","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/j.clnu.2023.07.011","article-title":"ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit","volume":"42","author":"Singer","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1177\/0884533616642746","article-title":"Nutrition in Toxic Epidermal Necrolysis: A Multicenter Review","volume":"31","author":"Graves","year":"2016","journal-title":"Nutr. Clin. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.burns.2016.07.026","article-title":"Steven Johnson Syndrome and Toxic Epidermal Necrolysis in a burn unit: A 15-year experience","volume":"43","author":"McCullough","year":"2017","journal-title":"Burns"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e450","DOI":"10.1097\/BCR.0000000000000336","article-title":"Toxic Epidermal Necrolysis with Gastrointestinal Involvement: A Case Report and Review of the Literature","volume":"38","author":"Brown","year":"2017","journal-title":"J. Burn. Care Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jaad.2013.05.002","article-title":"Toxic epidermal necrolysis: Part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis","volume":"69","author":"Schwartz","year":"2013","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e346","DOI":"10.1097\/BCR.0000000000000006","article-title":"Mesenteric ischemia secondary to toxic epidermal necrolysis: Case report and review of the literature","volume":"35","author":"Pradka","year":"2014","journal-title":"J. Burn. Care Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.alit.2015.09.001","article-title":"Retrospective analysis of Stevens-Johnson syndrome and toxic epidermal necrolysis in 87 Japanese patients\u2014Treatment and outcome","volume":"65","author":"Yamane","year":"2016","journal-title":"Allergol. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1007\/s00261-020-02639-8","article-title":"Intestinal pneumatosis: Differential diagnosis","volume":"47","author":"Lassandro","year":"2022","journal-title":"Abdom. Radiol."},{"key":"ref_45","first-page":"185","article-title":"Treatment of toxic epidermal necrolysis with moisture-retentive ointment: A case report and review of the literature","volume":"29","author":"Atiyeh","year":"2003","journal-title":"Dermatol. Surg."},{"key":"ref_46","first-page":"e55350","article-title":"To Debride or Not to Debride: A Review of Wound Management for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis","volume":"16","author":"Enescu","year":"2024","journal-title":"Cureus"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.burns.2017.10.022","article-title":"Treatment of toxic epidermal necrolysis by a multidisciplinary team. A review of literature and treatment results","volume":"44","author":"Papp","year":"2018","journal-title":"Burns"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/PRS.0b013e3181773d5d","article-title":"Antishear therapy for toxic epidermal necrolysis: An alternative treatment approach","volume":"122","author":"Dorafshar","year":"2008","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.bjps.2014.04.003","article-title":"Toxic epidermal necrolysis (TEN): The Chelsea and Westminster Hospital wound management algorithm","volume":"67","author":"Abela","year":"2014","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/00004630-200021030-00004","article-title":"A 10-year experience with toxic epidermal necrolysis","volume":"21","author":"Schulz","year":"2000","journal-title":"J. Burn. Care Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/MD.0b013e3181ca4290","article-title":"Bacteremia in Stevens-Johnson syndrome and toxic epidermal necrolysis: Epidemiology, risk factors, and predictive value of skin cultures","volume":"89","author":"Duong","year":"2010","journal-title":"Medicine"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jdcr.2020.04.003","article-title":"A pediatric case of Stevens-Johnson syndrome\/toxic epidermal necrolysis with rapid response to intravenous cyclosporine","volume":"6","author":"Alajmi","year":"2020","journal-title":"JAAD Case Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/pde.13778","article-title":"Pediatric toxic epidermal necrolysis treated successfully with infliximab","volume":"36","author":"Chafranska","year":"2019","journal-title":"Pediatr. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1111\/pde.14376","article-title":"Infantile toxic epidermal necrolysis: Successful treatment of an 8-week-old with intravenous immunoglobulin and amniotic membrane transplant","volume":"38","author":"Nassim","year":"2021","journal-title":"Pediatr. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e12832","DOI":"10.1111\/dth.12832","article-title":"Rapid remission of Stevens-Johnson syndrome by combination therapy using etanercept and intravenous immunoglobulin and a review of the literature","volume":"32","author":"Wang","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/1203475419861078","article-title":"Pediatric SJS\/TEN Subdued by a Combination of Dexamethasone, Cyclosporine, and Etanercept","volume":"23","author":"Coulombe","year":"2019","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jaad.2013.04.007","article-title":"Methylprednisolone pulse therapy for Stevens-Johnson syndrome\/toxic epidermal necrolysis: Clinical evaluation and analysis of biomarkers","volume":"69","author":"Hirahara","year":"2013","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jaad.2007.08.039","article-title":"Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective study on patients included in the prospective EuroSCAR Study","volume":"58","author":"Schneck","year":"2008","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1001\/jamadermatol.2016.5668","article-title":"Systemic Immunomodulating Therapies for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis","volume":"153","author":"Zimmermann","year":"2017","journal-title":"JAMA Dermatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/bjd.17841","article-title":"British Association of Dermatologists\u2019 guidelines for the management of Stevens-Johnson syndrome\/toxic epidermal necrolysis in children and young people, 2018","volume":"181","author":"McPherson","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1111\/j.1365-2133.2012.10965.x","article-title":"The efficacy of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis: A systematic review and meta-analysis","volume":"167","author":"Huang","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1111\/bjd.12607","article-title":"The role of intravenous immunoglobulin in toxic epidermal necrolysis: A retrospective analysis of 64 patients managed in a specialized centre","volume":"169","author":"Lee","year":"2013","journal-title":"Br. J. Dermatol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1126\/science.282.5388.490","article-title":"Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin","volume":"282","author":"Viard","year":"1998","journal-title":"Science"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.clim.2009.09.006","article-title":"Exposure of NK cells to intravenous immunoglobulin induces IFN gamma release and degranulation but inhibits their cytotoxic activity","volume":"133","author":"Jacobi","year":"2009","journal-title":"Clin. Immunol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jaad.2011.12.014","article-title":"Toxic epidermal necrolysis: Five years of treatment experience from a burn unit","volume":"67","author":"Firoz","year":"2012","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Ye, L.P., Zhang, C., and Zhu, Q.X. (2016). The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0167120"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1111\/j.1365-4632.2009.04166.x","article-title":"Combination therapy of intravenous immunoglobulin and corticosteroid in the treatment of toxic epidermal necrolysis and Stevens-Johnson syndrome: A retrospective comparative study in China","volume":"48","author":"Yang","year":"2009","journal-title":"Int. J. Dermatol."},{"key":"ref_68","first-page":"743","article-title":"High-dose intravenous immunoglobulins in the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis in Chinese patients: A retrospective study of 82 cases","volume":"20","author":"Chen","year":"2010","journal-title":"Eur. J. Dermatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.dsi.2017.04.004","article-title":"Efficacy of cyclosporine for the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis: Systemic review and meta-analysis","volume":"35","author":"Chen","year":"2017","journal-title":"Dermatol. Sin."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jcrc.2017.07.002","article-title":"Successful treatment of toxic epidermal necrolysis using plasmapheresis: A prospective observational study","volume":"42","author":"Han","year":"2017","journal-title":"J. Crit. Care."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1093\/ndt\/gfae089","article-title":"Hemoadsorption: Consensus report of the 30th Acute Disease Quality Initiative workgroup","volume":"39","author":"Bellomo","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e050464","DOI":"10.1136\/bmjopen-2021-050464","article-title":"Dosing of Extracorporeal Cytokine Removal in Septic Shock (DECRISS): Protocol of a prospective, randomised, adaptive, multicentre clinical trial","volume":"11","author":"Kanjo","year":"2021","journal-title":"BMJ Open"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/09546634.2019.1577548","article-title":"Biologic TNF-alpha inhibitors in the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis: A systemic review","volume":"31","author":"Zhang","year":"2020","journal-title":"J. Dermatol. Treat."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1172\/JCI93349","article-title":"Randomized, controlled trial of TNF-\u03b1 antagonist in CTL-mediated severe cutaneous adverse reactions","volume":"128","author":"Wang","year":"2018","journal-title":"J. Clin. Investig."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Shanbhag, S., Chodosh, J., Fathy, C., Goverman, J., Mitchell, C., and Saeed, H.N. (2021). Multidisciplinary care in Stevens-Johnson syndrome and toxic epidermal necrolysis with ocular involvement. Front. Med., 8.","DOI":"10.1177\/2040622319894469"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/8\/1238\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T08:27:19Z","timestamp":1785140839000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/8\/1238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":75,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["life16081238"],"URL":"https:\/\/doi.org\/10.3390\/life16081238","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]}}}