Adverse Cutaneous Reaction to Alternative Medical Therapy Clinical Trial
Official title:
Serum Interleukin -21 Level in Patients With Severe Adverse Cutaneous Drug Reaction and Correlation With Disease Severity.
Adverse cutaneous drug reactions are undesirable and typically unanticipated reactions independent of the intended therapeutic purpose of a medication. It may be either immunologic (eg, drug allergy) or non-immunologic. Adverse cutaneous drug reaction produce a wide range of clinical manifestations such as pruritus, maculopapular eruptions, urticaria, angioedema, phototoxic and photo allergic reactions, fixed drug reactions, erythema multiforme,vesiculobullous reactions (eg, Stevens-Johnson syndrome and toxic epidermal necrolysis) and serum sickness .They must be considered in the differential diagnosis of sudden symmetric eruption
Erythema multiforme is an acute immune mediated disorder It is a type IV hypersensitivity
reaction leading to dermal vasculitis. Erythema multiforme major usually as a result of
medications such as sulphonamides, non-steroidal anti-inflammatories and penicillin and
there is skin and mucosal involvement.
Steven-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are considered a spectrum
of acute life-threatening mucocutaneous reactions that differ only in severity. Both
diseases are characterized by mucous membrane and skin involvement, are often caused by
medications and are collectively known as epidermal necrolysis or scalded skin
syndrome.Stevens-Johnson syndrome (SJS) is classified as an epidermal loss <10% of the body
surface area.Toxic Epidermal Necrolysis (TEN) is indicated by >30% body surface area
erosion. The range of epidermal loss between 10% and 30% is called Stevens-Johnson
syndrome-Toxic Epidermal Necrolysis (SJS-TEN) overlap. Severity of illness score [Score of
Toxic Epidermal Necrolysis(TEN) ] has been devised to predict prognosis in patients with
Epidermal Necrolysis.This scoring system addresses 7 prognostic factors: age, malignancy,
heart rate,Body Surface Area involved, serum urea, serum glucose and serum bicarbonate
levels.
Interleukin-21 regulates both innate and adaptive immune responses and it is not only has
key roles in antitumour and antiviral responses that promote the development of autoimmune
diseases and inflammatory disorders. It is recently discovered member of the type 1 cytokine
family which is produced by activated clusters of differentiation 4+ T cells ,Natural killer
cells and follicular helper T cells.
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