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Comment on: Proposal for a new diagnostic classification of

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Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap (SJS/TEN), collectively referred to SJS/TEN, form a spectrum of severe life-threatening adverse drug reactions whose pathomechanism is not fully understood. The article "Photodistributed Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Proposal for a New Diagnostic Classification" by McKinley et. al., discusses a distinct distribution of epidermal necrosis in SJS/TEN, attributable to preceding exposure to ultraviolet radiation (UVR), and relative sparing of photo-protected areas. After reviewing numerous cases within the Immune-mediated Adverse drug Reactions in African HIV endemic setting Register and Biorepository (IMARI-SA) at the University of Cape Town with a similar clinical pattern as those published by McKinley et. al., we propose that the relative sparing of some areas giving an impression of photo-distribution is due to localised increase in skin pressure that reduces the blood supply in that area below a critical threshold. A dip in blood supply below this critical threshold quantitively limited T lymphocytes and cytokines that drive SJS/TEN to reach and damage the skin.

Advanced field laboratory setup used for Ebola virus disease outbreak

Rannakoe LEHLOENYA, Professor (Associate), FCDerm(SA), University of Cape Town, Cape Town, UCT, Department of Medicine, Division of Dermatology

Rannakoe LEHLOENYA, Professor (Associate), FCDerm(SA), University of Cape Town, Cape Town, UCT, Department of Medicine, Division of Dermatology

Sites in The Gambia (left) and Kenya (right).

Sites in The Gambia (left) and Kenya (right).

Georg Amun Hofmann's research works Medical University of Vienna, Vienna (MedUni Vienna) and other places

119923 PDFs Review articles in NECROSIS

Biobank sample workflow. Residual samples are biospecimens that are

Advanced field laboratory setup used for Ebola virus disease outbreak

294604 PDFs Review articles in SYSTEMATIC REVIEWS

100179 PDFs Review articles in ULTRAVIOLET RAYS

Georg Amun Hofmann's research works Medical University of Vienna, Vienna (MedUni Vienna) and other places