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33. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2015)

14.01. - 17.01.2015, Leogang, Österreich

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Toxic epidermal necrolysis and natural remedies

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  • A. Limbourg - Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover, Germany
  • A. Steiert - Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover, Germany
  • A. Jokuszies - Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover, Germany
  • K. Young - Department of Plastic Surgery, Frenchay Hospital, Bristol, United Kingdom
  • H. Adamas - Interdisziplinäre Notfall- und Katastrophenmedizin, Medizinische Hochschule Hannover, Hannover, Germany
  • P. Vogt - Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover, Germany

Deutschsprachige Arbeitsgemeinschaft für Verbrennungsbehandlung. 33. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2015). Leogang, Österreich, 14.-17.01.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dav08.09

doi: 10.3205/15dav78, urn:nbn:de:0183-15dav780

Published: March 9, 2015

© 2015 Limbourg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Toxic epidemal necrolysis (TEN) is a rare disease with a high mortality. Drugs are implicated in 70% of TEN cases. Twenty-five percent of hospitalised patients consume undisclosed herbal or dietary supplements [1]. Adverse reactions are described for many herbal preparations and may be induced by phytochemicals or undeclared contaminants.

An association of TEN as a severe adverse reaction to herbal remedies has yet to be established. Three TEN patients were admitted to our unit over one year, who developed TEN within four to five days following the ingestion of herbal remedy preparations. The objective evaluation by Naranjo adverse drug reaction (ADR) probability scale calculated a possible ADR by the herbal remedy in cases 1 and 3 and an even probable cause in case 2. In all cases, the TEN specific algorithm for epidermal necrolysis (ALDEN) confirmed a possible cause of hebal remedies for TEN development. A single or multiplier effect by idiosyncratic, dose-related or drug-interactive reactions of phytochemicals or contaminants might be involved in the development of TEN in these patients [2].

Outline

References

1.
Goldstein LH, Elias M, Ron-Avraham G, Biniaurishvili BZ, Madjar M, Kamargash I, Braunstein R, Berkovitch M, Golik A. Consumption of herbal remedies and dietary supplements amongst patients hospitalized in medical wards. Br J Clin Pharmacol. 2007 Sep;64(3):373-80. DOI: 10.1111/j.1365-2125.2007.02878.x External link
2.
Limbourg A, Steiert A, Jokuszies A, Young K, Adams HA, Vogt PM. Toxic epidermal necrolysis and natural remedies. Br J Dermatol. 2014 Dec;171(6):1583-5. DOI: 10.1111/bjd.13161 External link