Comment on: Proposal for a new diagnostic classification of

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.

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100179 PDFs Review articles in ULTRAVIOLET RAYS

Mean posterior probabilities from combined traces (circles) for C.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Ear, Nose, and Throat Description at Acute Stage and After Remission, Dermatology, JAMA Dermatology

119923 PDFs Review articles in NECROSIS

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

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

9917 PDFs Review articles in STEVENS-JOHNSON SYNDROME