Introduction: Toxic epidermal necrolysis (TEN) or Lyell syndrome is the most severe form of toxidermia. It is clinically characterised by a generalised exanthema with a skin detachment of more than 30% of the body surface area, which differentiates it from Stevens-Johnson syndrome (SJS), which affects less than 10% of the body surface area. Its management is essentially symptomatic. The aim of our study is to investigate the clinical, therapeutic and evolutionary aspects of Lyell syndrome. Materials and Method: We conducted a retrospective prospective cross-sectional and descriptive study over a period of 5 years (from 1 January 2014 to 31 December 2018). It concerned children from 1 month to 15 years old. Data were collected using a pre-established survey form and inpatient records. After informed consent from parents and the Head of Department, all information was collected in strict confidentiality. Results: During the study period, we were able to collect 10 patients meeting our inclusion criteria out of 9050 hospitalizations, or a frequency of 0.11%. The sex ratio was 4. The age group (6 months to 5 years) was the most affected with 60% of cases. Almost all patients (90%) consulted for skin lesions. The drugs frequently incriminated were non-steroidal anti-inflammatory drugs and anti-epileptics in equal proportions (20%). In 4 patients (40%), no drug could be clearly incriminated. On physical examination, NIKOLSKI's sign was found in 90% of patients. Management was essentially based on rehydration, antibiotic therapy, analgesics and local care. However, mortality remains very high (7 out of 10 patients). Conclusion: A rare but very serious pathology, Lyell syndrome has a poor prognosis in our context.
| Published in | Science Journal of Public Health (Volume 10, Issue 3) |
| DOI | 10.11648/j.sjph.20221003.11 |
| Page(s) | 106-109 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Lyell's Syndrome, Paediatrics Emergencies, UHC Gabriel Toure, Mali
| [1] | Bechir I. Prise en charge du syndrome de Lyell en réanimation. [Thèse de Médicine] Centre Hospitalier Universitaire Hassan II-FES 2013; N°087/13. [Management of Lyell's syndrome in intensive care. [Thesis of Medicine] Hassan University Hospital II-FES 2013; N°087/13]. |
| [2] | S. Siah, A. Baite, H. Bakkali, M. Atmani, K. Prise en Charge du Syndrome de Lyell ou Necrolyse Epidermique Toxique. [Management of Lyell's Syndrome or Toxic Epidermal Necrolysis]. Ann Burns Fire Disasters 2009; 22 (3): 142–146. |
| [3] | Roujeau JC. Syndromes de Lyell et de Stevens-Johnson. [Lyell and Stevens-Johnson syndromes]. Rev Prat 2007; 57: 1165-70. |
| [4] | Kourouma S, Sangaré A, Kaloga A, Kouassi I. Syndromes de Stevens-Johnson et de Lyell: étude de185 cas au CHU de Treichville (Abidjan, Côte d'Ivoire). [Stevens-Johnson and Lyell syndromes: a study of 185 cases at Treichville University Hospital (Abidjan, Ivory Coast)]. Médecine et Santé Tropicales 2014; 24: 94-98. |
| [5] | Mion G, Bordier E, Daban JL. Atteintes viscérales, physiopathologie et traitement du syndrome de Lyell. [Visceral involvement, pathophysiology and treatment of Lyell syndrome]. Ann Fr Anesth Réa 2006; 25 (9): 1011-101 8. |
| [6] | Paquet, E Jacob, P Damas, GE Piérard. Treatment of drug-induced toxicepidermal necrolysis (Lyell’s syndrome) with intravenous human immunoglobulins. Burns J Int Soc Burn Inj 2001; 36: 652-5. |
| [7] | Baroni A, Ruocco E. Lyell’s syndrome. Skin Med 2007; 4 (4): 221-225. |
| [8] | Pham CH, Gillenwater TJ, Nagengast E, Mc Cullough MC. Combination therapy: Etanercept and intravenous immunoglobulin for the acute treatment of Stevens Johnson syndrome/toxic epidermal necrolysis. Burns J Int Soc Burn Inj 2019; 45 (7): 1634-1638. |
| [9] | Akakpo AB, Saka B, Abilogoun Chokki AE, Teclessou JN. Stevens Johnson and Lyell sondromes in children in a hospital setting in Lomé, Togo, from 2000 to 2015. Med SanteTrop 2018; 28 (2): 332-333. |
| [10] | Ministère de la Santé: Enquête Démographique et de Santé du Mali (EDSM-V) Mai 2014. [Ministry of Health: Mali Demographic and Health Survey (EDSM-V) May 2014]. Available on: www.santé.gov.ml. |
| [11] | Nassira C. Toxidermies médicamenteuses: étude ambispictive au Centre Hospitalier Universitaire Hassan II de FES [Thèse de Médecine] Université Mohammed V-SOUISSI 2014; N°29. [Drug-induced toxicity: an ambispictive study at the Hassan II University Hospital of FES [Medical thesis] Mohammed V-SOUISSI University 2014; N°29]. |
| [12] | Yang SC, Hu S, Zhang SZ, Huang JW. The epidemiology of Stevens Johnson Syndrome and Toxic Epidermal Necrolysis in China. J Immuunol Res 2018; 11: 4320195. |
| [13] | Mario L, Pietro M, Antonio B, Corrado R. Toxicepidermal necrolysis (Lyell’s desease). Burns J Int Soc Burn inj 2010; 36 (2): 152-63. |
| [14] | Tchetnya X, Ngwasiri CA, Munge T, Aminde LN. Severe eye complications from toxic epidermal necrolysis following initiation of Nevirapine based HAART regimen in a child with HIV infection: a case from Cameroon. BMC Pediatrics 2018; 18 (1): 108. |
APA Style
Dembele Adama, Maiga Belco, Cisse Mohamed Elmouloud, Doumbia Abdoul Karim, Cissoko Nia, et al. (2022). Lyell Syndrome in the Pediatric Emergency Room of the University Hospital Center (UHC) Gabriel Toure. Science Journal of Public Health, 10(3), 106-109. https://doi.org/10.11648/j.sjph.20221003.11
ACS Style
Dembele Adama; Maiga Belco; Cisse Mohamed Elmouloud; Doumbia Abdoul Karim; Cissoko Nia, et al. Lyell Syndrome in the Pediatric Emergency Room of the University Hospital Center (UHC) Gabriel Toure. Sci. J. Public Health 2022, 10(3), 106-109. doi: 10.11648/j.sjph.20221003.11
AMA Style
Dembele Adama, Maiga Belco, Cisse Mohamed Elmouloud, Doumbia Abdoul Karim, Cissoko Nia, et al. Lyell Syndrome in the Pediatric Emergency Room of the University Hospital Center (UHC) Gabriel Toure. Sci J Public Health. 2022;10(3):106-109. doi: 10.11648/j.sjph.20221003.11
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author = {Dembele Adama and Maiga Belco and Cisse Mohamed Elmouloud and Doumbia Abdoul Karim and Cissoko Nia and Coulibaly Oumar and Sacko Karamoko and Issa Amadou and Dembele Guediouma and Karabinta Yamoussa and Coulibaly Yacaria and Togo Pierre and Sidibe Lala Ndrainy and Konate Djeneba and Diall Hawa Gouro and Traore Kalirou and Kone Oumou and Ahamadou Ibrahim and Diakite Abdoul Aziz and Konare Awa and Sylla Fatou and Togo Boubacar},
title = {Lyell Syndrome in the Pediatric Emergency Room of the University Hospital Center (UHC) Gabriel Toure},
journal = {Science Journal of Public Health},
volume = {10},
number = {3},
pages = {106-109},
doi = {10.11648/j.sjph.20221003.11},
url = {https://doi.org/10.11648/j.sjph.20221003.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20221003.11},
abstract = {Introduction: Toxic epidermal necrolysis (TEN) or Lyell syndrome is the most severe form of toxidermia. It is clinically characterised by a generalised exanthema with a skin detachment of more than 30% of the body surface area, which differentiates it from Stevens-Johnson syndrome (SJS), which affects less than 10% of the body surface area. Its management is essentially symptomatic. The aim of our study is to investigate the clinical, therapeutic and evolutionary aspects of Lyell syndrome. Materials and Method: We conducted a retrospective prospective cross-sectional and descriptive study over a period of 5 years (from 1 January 2014 to 31 December 2018). It concerned children from 1 month to 15 years old. Data were collected using a pre-established survey form and inpatient records. After informed consent from parents and the Head of Department, all information was collected in strict confidentiality. Results: During the study period, we were able to collect 10 patients meeting our inclusion criteria out of 9050 hospitalizations, or a frequency of 0.11%. The sex ratio was 4. The age group (6 months to 5 years) was the most affected with 60% of cases. Almost all patients (90%) consulted for skin lesions. The drugs frequently incriminated were non-steroidal anti-inflammatory drugs and anti-epileptics in equal proportions (20%). In 4 patients (40%), no drug could be clearly incriminated. On physical examination, NIKOLSKI's sign was found in 90% of patients. Management was essentially based on rehydration, antibiotic therapy, analgesics and local care. However, mortality remains very high (7 out of 10 patients). Conclusion: A rare but very serious pathology, Lyell syndrome has a poor prognosis in our context.},
year = {2022}
}
TY - JOUR T1 - Lyell Syndrome in the Pediatric Emergency Room of the University Hospital Center (UHC) Gabriel Toure AU - Dembele Adama AU - Maiga Belco AU - Cisse Mohamed Elmouloud AU - Doumbia Abdoul Karim AU - Cissoko Nia AU - Coulibaly Oumar AU - Sacko Karamoko AU - Issa Amadou AU - Dembele Guediouma AU - Karabinta Yamoussa AU - Coulibaly Yacaria AU - Togo Pierre AU - Sidibe Lala Ndrainy AU - Konate Djeneba AU - Diall Hawa Gouro AU - Traore Kalirou AU - Kone Oumou AU - Ahamadou Ibrahim AU - Diakite Abdoul Aziz AU - Konare Awa AU - Sylla Fatou AU - Togo Boubacar Y1 - 2022/05/12 PY - 2022 N1 - https://doi.org/10.11648/j.sjph.20221003.11 DO - 10.11648/j.sjph.20221003.11 T2 - Science Journal of Public Health JF - Science Journal of Public Health JO - Science Journal of Public Health SP - 106 EP - 109 PB - Science Publishing Group SN - 2328-7950 UR - https://doi.org/10.11648/j.sjph.20221003.11 AB - Introduction: Toxic epidermal necrolysis (TEN) or Lyell syndrome is the most severe form of toxidermia. It is clinically characterised by a generalised exanthema with a skin detachment of more than 30% of the body surface area, which differentiates it from Stevens-Johnson syndrome (SJS), which affects less than 10% of the body surface area. Its management is essentially symptomatic. The aim of our study is to investigate the clinical, therapeutic and evolutionary aspects of Lyell syndrome. Materials and Method: We conducted a retrospective prospective cross-sectional and descriptive study over a period of 5 years (from 1 January 2014 to 31 December 2018). It concerned children from 1 month to 15 years old. Data were collected using a pre-established survey form and inpatient records. After informed consent from parents and the Head of Department, all information was collected in strict confidentiality. Results: During the study period, we were able to collect 10 patients meeting our inclusion criteria out of 9050 hospitalizations, or a frequency of 0.11%. The sex ratio was 4. The age group (6 months to 5 years) was the most affected with 60% of cases. Almost all patients (90%) consulted for skin lesions. The drugs frequently incriminated were non-steroidal anti-inflammatory drugs and anti-epileptics in equal proportions (20%). In 4 patients (40%), no drug could be clearly incriminated. On physical examination, NIKOLSKI's sign was found in 90% of patients. Management was essentially based on rehydration, antibiotic therapy, analgesics and local care. However, mortality remains very high (7 out of 10 patients). Conclusion: A rare but very serious pathology, Lyell syndrome has a poor prognosis in our context. VL - 10 IS - 3 ER -
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