Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus

被引：40

作者：

Brueggen, M. -C. ^{[1
,2
,3
,4
]}

Le, S. T. ^{[5
]}

Walsh, S. ^{[4
,6
]}

Toussi, A. ^{[5
]}

de Prost, N. ^{[7
,10
]}

Ranki, A. ^{[4
,11
,12
]}

Didona, B. ^{[4
,13
]}

Colin, A. ^{[4
,8
,10
]}

Horvath, B. ^{[4
,14
]}

Brezinova, E. ^{[4
,15
]}

Milpied, B. ^{[4
,10
,16
]}

Moss, C. ^{[4
,17
,18
]}

Bodemer, C. ^{[4
,10
,19
]}

Meyersburg, D. ^{[4
,20
]}

Salavastru, C. ^{[4
,21
]}

Tiplica, G. -S. ^{[4
,22
]}

Howard, E. ^{[4
,17
,18
]}

Bequignon, E. ^{[4
,9
]}

Bouwes Bavinck, J. N. ^{[23
]}

Newman, J. ^{[24
]}

Gueudry, J. ^{[10
,25
]}

Naegeli, M. ^{[1
]}

Zaghbib, K. ^{[10
,26
]}

Pallesen, K. ^{[4
,27
]}

Bygum, A. ^{[4
,28
]}

Joly, P. ^{[4
,10
,29
]}

Wolkenstein, P. ^{[4
,8
,10
]}

Chua, S. -L. ^{[4
,30
]}

Le Floch, R. ^{[10
,31
]}

Shear, N. H. ^{[32
,33
]}

Chu, C. -Y. ^{[34
,35
]}

Hama, N. ^{[36
]}

Abe, R. ^{[36
]}

Chung, W. -H. ^{[37
]}

Shiohara, T. ^{[38
]}

Arden-Jones, M. ^{[39
]}

Romanelli, P. ^{[40
]}

Phillips, E. J. ^{[41
]}

Stern, R. S. ^{[42
]}

Cotliar, J. ^{[43
]}

Micheletti, R. G. ^{[44
]}

Brassard, A. ^{[5
]}

Schulz, J. T. ^{[45
]}

Dodiuk-Gad, R. P. ^{[34
]}

Dominguez, A. R. ^{[46
]}

Paller, A. S. ^{[47
,48
]}

Vidal, L. S. ^{[49
]}

Mostaghimi, A. ^{[50
]}

Noe, M. H. ^{[50
]}

Worswick, S. ^{[51
]}

机构：

[1] Univ Hosp Zurich, Dept Dermatol, Zurich, Switzerland

[2] Univ Zurich, Fac Med, Zurich, Switzerland

[3] Christine Kuhne Ctr Allergy Res & Educ, Davos, Switzerland

[4] European Reference Network Rare Skin Dis ERN Skin, ToxiTEN Grp, Paris, France

[5] Univ Calif Davis, Dept Dermatol, Sacramento, CA 95817 USA

[6] Kings Coll Hosp London, Dept Dermatol, London, England

[7] Henri Mondor Hosp, AP HP, Intens Care Unit, Creteil, France

[8] Henri Mondor Hosp, AP HP, Dept Dermatol, Creteil, France

[9] Henri Mondor Hosp, AP HP, Dept Otorhinolaryngol & Head & Neck Surg, Creteil, France

[10] Henri Mondor Hosp, AP HP, Filiere FIMARAD, Tox Bullous Dermatoses TOXIBUL Reference Ctr, Creteil, France

[11] Univ Helsinki, Dept Skin & Allerg Dis, Helsinki, Finland

[12] Helsinki Univ Cent Hosp, Helsinki, Finland

[13] Inst Dermopat Immacolata IDI IRCCS, Dermatol Div 1, Via Monti Creta 104, I-00167 Rome, Italy

[14] Univ Groningen, Univ Med Ctr Groningen, Dept Dermatol, Ctr Blistering Dis, Groningen, Netherlands

[15] Masaryk Univ, St Anns Univ Hosp, Fac Med, Dept Dermatovenereol, Brno, Czech Republic

[16] CHU Bordeaux, Dept Dermatol, Bordeaux, France

[17] Birmingham Childrens Hosp, Birmingham, W Midlands, England

[18] Univ Birmingham, Birmingham, W Midlands, England

[19] Hop Necker Enfants Malad, AP HP, Dept Dermatol, Paris, France

[20] Paracelsus Med Univ, Univ Hosp Salzburg, Dept Dermatol & Allergol, Salzburg, Austria

[21] Carol Davila Univ Med & Pharm, Colentina Clin Hosp, Dept Paediat Dermatol, Bucharest, Romania

[22] Carol Davila Univ Med & Pharm, Colentina Clin Hosp, Dept Dermatol 2, Bucharest, Romania

[23] Leiden Univ, Med Ctr, Dept Dermatol, Leiden, Netherlands

[24] Macmillan Skin Canc CNS, Normanby Bldg,Denmark Hill, London, England

[25] Rouen Univ, Ophthalmol Dept, Hosp Charles Nicolle, EA7510,UFR Sante, Rouen, France

[26] Henri Mondor Albert Chenevier Hosp, AP HP, Dept Psychiat, Creteil, France

[27] Aarhus Univ Hosp, Dept Dermatol, Aarhus, Denmark

[28] Univ Southern Denmark, Clin Inst, Dept Clin Genet, Odense Univ Hosp, Odense, Denmark

[29] CHU Charles, Dept Dermatol, Rouen, France

[30] Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England

[31] CHU Nantes, PTMC, Reanimat Chirurg & Brules, Nantes, France

[32] Univ Toronto, Div Clin Pharmacol & Toxicol, Toronto, ON, Canada

[33] Sunnybrook Hlth Sci Ctr, Div Dermatol, Toronto, ON, Canada

[34] Natl Taiwan Univ Hosp, Dept Dermatol, Taipei, Taiwan

[35] Natl Taiwan Univ, Coll Med, Taipei, Taiwan

[36] Niigata Univ, Grad Sch Med & Dent Sci, Niigata, Japan

[37] Chang Gung Mem Hosp, Drug Hypersensit Clin & Res Ctr, Dept Dermatol, Taoyuan, Taiwan

[38] Kyorin Univ, Sch Med, Dept Dermatol, Tokyo, Japan

[39] Univ Southampton, Fac Med, Clin Expt Sci, Southampton, Hants, England

[40] Univ Miami, Miller Sch Med, Dept Dermatol & Cutaneous Surg, Miami, FL 33136 USA

[41] Vanderbilt Univ, Med Ctr, Dept Med & Pharmacol, Nashville, TN USA

[42] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA

[43] Sci 37, Los Angeles, CA USA

[44] Univ Penn, Dept Dermatol, Perelman Sch Med, Philadelphia, PA 19104 USA

[45] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA 02115 USA

[46] Univ Texas Southwestern Med Ctr Dallas, Dept Dermatol, Dept Internal Med, Dallas, TX USA

[47] Northwestern Univ, Dept Dermatol, Feinberg Sch Med, Chicago, IL 60611 USA

[48] Northwestern Univ, Dept Pediat, Feinberg Sch Med, Chicago, IL 60611 USA

[49] Univ S Florida, Dept Dermatol, Cutaneous Oncol Program, Moffitt Canc Ctr, Tampa, FL 33620 USA

[50] Harvard Med Sch, Dept Dermatol, Brigham & Womens Hosp, Boston, MA 02115 USA

来源：

BRITISH JOURNAL OF DERMATOLOGY | 2021年 / 185卷 / 03期

关键词：

D O I：

10.1111/bjd.19893

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Background Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.

引用

页码：616 / 626

页数：11

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