Toxic epidermal necrolysis
Toxic epidermal necrolysis (Stevens-Johnson syndrome) is a life-threatening skin disorder caused by drugs or infections characterized by widespread epidermal necrosis.
Toxic epidermal necrolysis is a severe form of erythema multiforme.
A similar situation occurs in humans, caused by drugs reactions and zoonotic infections with Capnocytophaga canimorsus. The consequent involvement of staphylococcal exfoliatin produced by Staphylococcus spp also plays a role in the exfoliative phenomenon associated with Stevens-Johnson syndrome. However, this scenario of bacterial induced exfoliation has been shown to be absent in dogs.
As well as manifesting as a severe necrosis of skin, systemic symptoms are usually present and affected dogs often present with anorexia, lethargy, hepatopathy, dyspnoea and fever.
Treatment requires immediate discontinuation of drug therapy which has induced the epidermal necrolysis.
This is followed by intensive dermal therapy with skin protectants, thermal water sprays, non-stick dressings and antimicrobial creams.
Resolution can be frustrating as severe dermal loss can rapidly result in a fulminating sepsis and death.
In one dog, a single intravenous infusion of 0.51 g/kg human immunoglobulin (ivHIG) as a 5 per cent solution was effective as an adjunct therapy.
- Uni of Pennsylvania
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