Management of Ocular Manifestations in Toxic Epidermolisis: An Emergency? A Case Series

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AIM: To evaluate ocular manifestations and treatment of patients with ocular involvement in toxic epidermolysis disease spectrum. METHODS. We retrospectively reviewed the files of patient’s diagnosed toxic epidermal necrolysis or Lyells disease / Stevens Johnson Syndrome attending the Ophthalmology Unit in the University Hospital center in Yaoundé (CHUY) from 2005 to 2011. The outcome measure were etiological factors causing Stevens Johnson syndrome / Toxic epidermal necrolysis (TEN), the pattern of ocular lesions and the management. RESULTS: Sixteen patients were managed. All patients had bilateral involvement but with asymmetrical presentations with a higher female representation (sex ratio F/M of 2:2) . Three of these were known HIV infected and were taking antiretroviral drugs. The mean times lag from onset of symptoms to the ophthalmologist consultation was 14.91 days (range 5 -35 days). Lids involvement was noted in 87, 50 % of cases followed by infections in 68, 75% of cases. All patients were managed medically with topical antibiotics and local anesthetic with preservatives. The most frequently identified possible cause was the antimalarial drugs in 50% of cases. CONCLUSION: Toxic epidermolysis should be considered as an ocular emergency to be presented to ophthalmologist as soon as the diagnosis is made. Preservatives free antibiotics should be used to reduce the local toxicity of the ocular surface.

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Stevens Johnson syndrome , Toxic epidermal necrolysis TEN , eye , ocular emergency

Health Sciences an‎d Diseases

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Health Sciences an‎d Diseases