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  1. Article ; Online: Stevens-Johnson Syndrome and toxic epidermal necrolysis: improving the support to victims.

    Roujeau, Jean-Claude

    Drug safety

    2013  Volume 36, Issue 2, Page(s) 145–146

    MeSH term(s) Drug-Related Side Effects and Adverse Reactions ; Humans ; Internet ; Stevens-Johnson Syndrome/chemically induced ; Stevens-Johnson Syndrome/etiology
    Language English
    Publishing date 2013-01-17
    Publishing country New Zealand
    Document type Journal Article ; Comment
    ZDB-ID 1018059-x
    ISSN 1179-1942 ; 0114-5916
    ISSN (online) 1179-1942
    ISSN 0114-5916
    DOI 10.1007/s40264-012-0008-4
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  2. Article ; Online: Virus Reactivation in Drug Reaction with Eosinophilia and Systemic Symptoms (Dress) Results from a Strong Drug-Specific Immune Response.

    Roujeau, Jean-Claude / Dupin, Nicolas

    The journal of allergy and clinical immunology. In practice

    2017  Volume 5, Issue 3, Page(s) 811–812

    MeSH term(s) Ceftriaxone ; Drug Hypersensitivity Syndrome ; Eosinophilia ; Humans ; Patch Tests
    Chemical Substances Ceftriaxone (75J73V1629)
    Language English
    Publishing date 2017-04-28
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2016.11.027
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  3. Article ; Online: Epidermal Necrolysis, Ocular Complications, and "Cold Medicines".

    Roujeau, Jean-Claude / Dunant, Ariane / Mockenhaupt, Maja

    The journal of allergy and clinical immunology. In practice

    2018  Volume 6, Issue 2, Page(s) 703–704

    MeSH term(s) Humans ; Stevens-Johnson Syndrome
    Language English
    Publishing date 2018-03-07
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2017.10.033
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  4. Article ; Online: New Evidence Supporting Cyclosporine Efficacy in Epidermal Necrolysis.

    Roujeau, Jean-Claude / Mockenhaupt, Maja / Guillaume, Jean-Claude / Revuz, Jean

    The Journal of investigative dermatology

    2017  Volume 137, Issue 10, Page(s) 2047–2049

    Abstract: Sixty years after its original description by Sir Alan Lyell, epidermal necrolysis (from Stevens-Johnson syndrome to toxic epidermal necrolysis) seems finally amenable to a specific treatment in addition to essential symptomatic measures in specialized ... ...

    Abstract Sixty years after its original description by Sir Alan Lyell, epidermal necrolysis (from Stevens-Johnson syndrome to toxic epidermal necrolysis) seems finally amenable to a specific treatment in addition to essential symptomatic measures in specialized settings. A recently published systematic review and an article by Gonzales-Herrada et al. strongly suggest that cyclosporine is effective in reducing the risk of death.
    MeSH term(s) Cyclosporine/therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Practice Guidelines as Topic ; Stevens-Johnson Syndrome/drug therapy
    Chemical Substances Immunosuppressive Agents ; Cyclosporine (83HN0GTJ6D)
    Language English
    Publishing date 2017-10-06
    Publishing country United States
    Document type Journal Article ; Review ; Comment
    ZDB-ID 80136-7
    ISSN 1523-1747 ; 0022-202X
    ISSN (online) 1523-1747
    ISSN 0022-202X
    DOI 10.1016/j.jid.2017.07.828
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  5. Article: Syndromes de Lyell et de Stevens-Johnson.

    Roujeau, Jean-Claude

    La Revue du praticien

    2007  Volume 57, Issue 11, Page(s) 1165–1170

    Abstract: Epidermal necrolysis (Stevens-Johnson syndrome, toxic epidermal necrolysis) is an acute and severe skin disease, induced by "(drug allergy" and characterized by the destruction of the epithelium of the skin and mucous membranes. It is extremely rare: ... ...

    Title translation Toxic epidermal necrolysis and Stevens-Johnson syndrome.
    Abstract Epidermal necrolysis (Stevens-Johnson syndrome, toxic epidermal necrolysis) is an acute and severe skin disease, induced by "(drug allergy" and characterized by the destruction of the epithelium of the skin and mucous membranes. It is extremely rare: about 2 cases per million per year. It is a life-threatening emergency. Blisters and detachment may involve a high portion of the body surface area and several mucosal sites. Visceral complications are frequent. The clinical diagnosis should be confirmed by a skin biopsy showing full-thickness necrosis of the epidermis. A dozen "high risk" medications account for 50% of cases. Symptomatic management in specialized units is urgent. The mortality rate is high (20-25%) and about one half of survivors will have sequelae, especially on the eyes.
    MeSH term(s) Adult ; Biopsy ; Diagnosis, Differential ; France/epidemiology ; Genetic Counseling ; Humans ; Prognosis ; Risk Factors ; Skin/pathology ; Stevens-Johnson Syndrome/diagnosis ; Stevens-Johnson Syndrome/epidemiology ; Stevens-Johnson Syndrome/etiology ; Stevens-Johnson Syndrome/genetics ; Stevens-Johnson Syndrome/mortality ; Stevens-Johnson Syndrome/pathology ; Stevens-Johnson Syndrome/therapy
    Language French
    Publishing date 2007-06-15
    Publishing country France
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 205365-2
    ISSN 2101-017X ; 0035-2640
    ISSN (online) 2101-017X
    ISSN 0035-2640
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  6. Article: Who should support the costs of severe adverse drug reactions?

    Roujeau, Jean-Claude / Le Pallec, Sophie

    Therapeutic advances in drug safety

    2014  Volume 2, Issue 1, Page(s) 5–8

    Language English
    Publishing date 2014-07-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2583589-0
    ISSN 2042-0994 ; 2042-0986
    ISSN (online) 2042-0994
    ISSN 2042-0986
    DOI 10.1177/2042098610396118
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  7. Article: Immune mechanisms in drug allergy.

    Roujeau, Jean-Claude

    Allergology international : official journal of the Japanese Society of Allergology

    2006  Volume 55, Issue 1, Page(s) 27–33

    Abstract: Clinicians had suspected for years that drug eruptions were probably mediated by immune mechanisms because their timing suggested sensitization and specific immunologic memory rather than direct toxicity. An immune response to medications was also ... ...

    Abstract Clinicians had suspected for years that drug eruptions were probably mediated by immune mechanisms because their timing suggested sensitization and specific immunologic memory rather than direct toxicity. An immune response to medications was also demonstrated by positive skin tests and by several types of in vitro tests that evidenced immediate or delayed hypersensitivity. In the last decade several teams of researchers obtained in vitro drug-specific human T-cell clones, in a variety of clinical types of drug eruptions. These clones were produced from blood or skin mononuclear cells of patients with a history of drug reaction by stimulation in vitro with drug. They were either of CD4 or CD8 phenotypes. Drug specific clones were stimulated by the parent drug much more often than by reactive metabolites. That challenged the classical "hapten hypothesis" that the immune response was initiated by reactive metabolites combined to self proteins. The medication usually stimulated specific T-cells after non-covalent binding to major histocompatibility (MHC) molecules on antigen presenting cells. In toxic epidermal necrolysis, T-lymphocytes present at the site of lesions, exhibited a drug specific cytotoxicity against autologous target cells, or allogeneic cells that shared the same HLA than autologous cells. This MHC class I restriction and mediation of death by perforin/granzyme release, is the classical behavior of cytotoxic T lymphocytes, like those operating in the reject of a transplanted organ. MHC restriction could explain the key role of HLA genes as predisposing factors to severe drug reactions. A strong association between HLA and hypersensitivity to abacavir, SJS or TEN to carbamazepine or allopurinol has been recently demonstrated. Resemblance to graft rejection points to the possible therapeution value of immuno suppressive agents. Most drug eruptions appear to result from T-cell mediated delayed hypersensitivity. The secondary activation of different cascades of cytokines, may contribute to the heterogeneity of clinical presentations.
    MeSH term(s) Cytokines/immunology ; Drug Eruptions/drug therapy ; Drug Eruptions/immunology ; Drug Eruptions/prevention & control ; Drug Hypersensitivity/drug therapy ; Drug Hypersensitivity/immunology ; Drug Hypersensitivity/prevention & control ; Humans ; T-Lymphocytes/drug effects ; T-Lymphocytes/immunology
    Chemical Substances Cytokines
    Language English
    Publishing date 2006-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1336498-4
    ISSN 1440-1592 ; 1323-8930
    ISSN (online) 1440-1592
    ISSN 1323-8930
    DOI 10.2332/allergolint.55.27
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    Zs.A 5248: Show issues Location:
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  8. Article ; Online: Comments on: DRESS syndrome.

    Kardaun, Sylvia H / Mockenhaupt, Maja / Roujeau, Jean-Claude

    Journal of the American Academy of Dermatology

    2014  Volume 71, Issue 5, Page(s) 1000–1000.e2

    MeSH term(s) Drug Eruptions/etiology ; Drug Eruptions/physiopathology ; Drug Hypersensitivity/etiology ; Drug Hypersensitivity/physiopathology ; Eosinophilia/etiology ; Eosinophilia/physiopathology ; Humans
    Language English
    Publishing date 2014-11
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 603641-7
    ISSN 1097-6787 ; 0190-9622
    ISSN (online) 1097-6787
    ISSN 0190-9622
    DOI 10.1016/j.jaad.2013.11.053
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  9. Article: Clinical heterogeneity of drug hypersensitivity.

    Roujeau, Jean-Claude

    Toxicology

    2005  Volume 209, Issue 2, Page(s) 123–129

    Abstract: Skin is the most frequent target of drug reactions that are reported, may be because they are easily detected. Most (probably more than 90%) are related to drug hypersensitivity, i.e. an individually tailored, unexpected effect mediated by a drug ... ...

    Abstract Skin is the most frequent target of drug reactions that are reported, may be because they are easily detected. Most (probably more than 90%) are related to drug hypersensitivity, i.e. an individually tailored, unexpected effect mediated by a drug specific activation of the immune response. The clinical presentation of "drug eruptions" is highly variable, from the most common transient and benign erythema that occurs 6-9 days after the introduction of a new drug in 1 to 3 % of users to the most severe forms, that fortunately affect less than 1/10,000 users. Even though there are some overlapping or unclassifiable cases, it is important for clinicians to recognize and categorize severe cutaneous adverse reactions/SCAR (bullous fixed drug eruptions/bFDE, acute generalized exanthematous pustulosis/AGEP, drug reaction with eosinophilia and systemic symptoms/DRESS, Stevens-Johnson syndrome/SJS, toxic epidermal necrolysis/TEN). First they must suspect rapidly that an unusual eruption with high fever and severe constitutional symptoms is caused by a medication and not by an infection. Second they have to look for involvement of organs that differ according to the type of reaction. Third they can determine a prognosis, the mortality rate being virtually 0 for bFDE, 5% for AGEP, 10% for "hypersensitivity syndrome"/DRESS and 25% for SJS or TEN. In addition if some medications are "usual suspects" for all types (e.g. anticonvulsants), some other are more specific of a given pattern (pristinamycine, hydroxychloroquine, diltiazem for AGEP, minocycline for DRESS, anti-infectious sulfonamides, allopurinol for epidermal necrolysis). The "phenotypic" diversity of the final expression drug reactions can be explained by the engagement of a variety of cytokines and inflammatory cells and by regulatory mechanisms. For example, memory cytotoxic T-Cells are key effectors in both localized blisters of bFDE and in extensive blisters of epidermal necrolysis.
    MeSH term(s) Animals ; Drug Eruptions/complications ; Drug Eruptions/immunology ; Drug Eruptions/pathology ; Drug Hypersensitivity/complications ; Drug Hypersensitivity/immunology ; Drug Hypersensitivity/pathology ; Humans ; Skin/pathology
    Language English
    Publishing date 2005-04-15
    Publishing country Ireland
    Document type Journal Article ; Review
    ZDB-ID 184557-3
    ISSN 1879-3185 ; 0300-483X
    ISSN (online) 1879-3185
    ISSN 0300-483X
    DOI 10.1016/j.tox.2004.12.022
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  10. Article ; Online: Anwendung von hochdosierten intravenösen Immunglobulinen in der Dermatologie JDDG 2009; 7:806-813.

    Mockenhaupt, Maja / Roujeau, Jean-Claude

    Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG

    2010  Volume 8, Issue 5, Page(s) 386–7; author reply 387–9

    Title translation Use of high dose intravenous immunoglobulins in dermatology.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Germany ; Humans ; Immunization, Passive/methods ; Practice Guidelines as Topic ; Stevens-Johnson Syndrome/therapy
    Chemical Substances Adrenal Cortex Hormones
    Language German
    Publishing date 2010-05
    Publishing country Germany
    Document type Comment ; Letter
    ZDB-ID 2093479-8
    ISSN 1610-0387 ; 1610-0379
    ISSN (online) 1610-0387
    ISSN 1610-0379
    DOI 10.1111/j.1610-0387.2010.07379.x
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