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Toxic epidermal necrolysis with severe hyperbilirubinemia: Complete re‐epithelialization after bilirubin reduction therapies
Author(s) -
KAMADA Noriaki,
YONEYAMA Kei,
TOGAWA Yaei,
SUEHIRO Keisuke,
SHINKAI Hiroshi,
YOKOTA Masaya,
MATSUDA Kenichi,
ODA Shigeto,
HIRASAWA Hiroyuki,
MATSUE Hiroyuki
Publication year - 2010
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2009.00770.x
Subject(s) - toxic epidermal necrolysis , bilirubin , medicine , dermatology , culprit , body surface area , total body surface area , erythroderma , gastroenterology , myocardial infarction
Toxic epidermal necrolysis is a life‐threatening skin disorder, and its mortality rate is estimated to be approximately 20–30%. It is characterized that more than 30% of the skin surface is eroded, however, skin lesions are usually re‐epithelialized within 2–3 weeks. Previously, we reported a fatal case of toxic epidermal necrolysis with hyperbilirubinemia, and more than 60% of body surface areas had been eroded for 9 weeks. For the reason of delayed re‐epithelialization, we hypothesized that hyperbilirubinemia was the culprit because bilirubin damaged cultured keratinocytes in vitro . In this case, we had an opportunity to treat another case of toxic epidermal necrolysis with severe hyperbilirubinemia. In order to reduce serum bilirubin levels, we performed bilirubin adsorption therapies, and skin lesions were successfully re‐epithelialized within 4 weeks. Though further studies are required, we considered that bilirubin adsorption therapies are worth trying for toxic epidermal necrolysis with hyperbilirubinemia, especially for the cases suffering from delayed re‐epithelialization.