home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
CD-ROM Today (UK) (Spanish) 15
/
CDRT.iso
/
dp
/
0394
/
03947.txt
< prev
next >
Wrap
Text File
|
1994-01-17
|
10KB
|
226 lines
$Unique_ID{BRK03947}
$Pretitle{}
$Title{Lyelles Syndrome}
$Subject{Lyelles Syndrome TEN Scalded Skin Syndrome Staphylococcal Scalded
Skin Syndrome Dermatitis Exfoliativa Ritter-Lyell Syndrome Ritter Disease
Lyell Syndrome Acute Toxic Epidermolysis Bullosa Stevens-Johnson Syndrome}
$Volume{}
$Log{}
Copyright (C) 1987, 1989 National Organization for Rare Disorders, Inc.
414:
Lyelles Syndrome
** IMPORTANT **
It is possible the main title of the article (Lyelles Syndrome) is not the
name you expected. Please check the SYNONYMS listing on the next page to find
alternate names, disorder subdivisions, and related disorders covered by this
article.
Synonyms
TEN
Scalded Skin Syndrome
Staphylococcal Scalded Skin Syndrome
Dermatitis Exfoliativa
Ritter-Lyell Syndrome
Ritter Disease
Lyell Syndrome
Acute Toxic Epidermolysis
Information on the following diseases can be found in the Related
Disorders section of this report:
Epidermolysis Bullosa
Stevens-Johnson Syndrome
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Lyelles Syndrome is a serious skin disorder characterized by severe
redness, blisters and peeling. Onset can begin during any stage of life.
The infantile form may follow an infection. In adults the disorder is often
caused by a drug reaction. Treatment of cases caused by infection may differ
from those caused by drug reactions.
Symptoms
Symptoms of infantile or childhood onset Lyelles Syndrome may have a
preliminary stage marked by fever, sore throat, eye inflammation
(conjunctivitis), nasal discharge, vomiting, diarrhea and/or back pain.
Development of crusted lesions around the nose or ear can be followed within
twenty-four hours by intense redness in the same area. Skin redness may
spread with tenderness, itching and separation of skin layers possibly
developing within thirty-six to forty-eight hours. Skin may peel away in
large sheets when touched. Blisters of various sizes may form along with
peeling. The severity of peeling skin is often related to the degree of
fever, severe discomfort, and loss of appetite. With healing, peeled areas
may become dried and yellowish crusts may appear in affected areas.
Large, easily broken blisters may be the first apparent symptom of adult
onset Lyelles Syndrome. These blisters may be associated with other skin
conditions such as Stevens-Johnson Syndrome (Erythema Multiforme Bullosum).
Large sheets of skin can peel due to slight injury or simply touching an
object and the mucous membranes may also be involved. Lyelles Syndrome
usually progresses rapidly and within a few days may become severe. Fluid
may be lost after extensive peeling occurs possibly leading to dehydration
like that which occurs in burn victims. Scars resembling those of burns may
develop when the skin begins to heal.
Causes
Lyelles Syndrome is often caused by bacterial (staphylococcal) infections
when infants or children are affected. A common staphylococcal skin
infection with blisters and crusting called Impetigo may also precede this
disorder. Lyelles Syndrome can occur sporadically or in epidemic proportions
in nurseries. An allergic reaction to a drug often causes symptoms to
develop during adulthood. Very rarely, some childhood cases may be linked to
a drug reaction.
Affected Population
Lyelles Syndrome affects males and females in equal numbers.
Related Disorders
Symptoms of the following disorders can be similar to those of Lyelles
Syndrome. Comparisons may be useful for a differential diagnosis:
Epidermolysis Bullosa (EB) is the name of a group of rare, hereditary
skin disorders in which blisters develop on many areas of the body. Severe
forms of the disease may include involvement of the mucous membranes,
internal digestive tract and other organs. Infection must be guarded against
and often scars cannot be avoided. (For more information on this disorder,
choose "EB" as your search term in the Rare Disease Database).
Stevens-Johnson Syndrome is another blistering skin disorder usually
affecting children and young adults. It is marked by severe reddening and
blisters on the skin and mucous membranes. A preliminary stage may last from
one to two weeks consisting of fever, discomfort, coughing linked to an acute
allergic reaction, sore throat, chest pain, vomiting, diarrhea, and joint or
muscle pain. Lesions may then appear in the mouth and throat as well as on
reproductive organs and the anal area. Progressive eye inflammation can lead
to diminished vision. Crusting with bleeding may develop on the lips.
Symptoms may heal within three to six weeks, but can recur at any time. The
cause of this disorder is not known, although more severe cases are possibly
associated with collagen disease, malignancy, contact dermatitis or drug
reactions. Stevens-Johnson usually appears in the fall or spring, for
reasons not yet understood by scientists. (For more inforation on this
disorder, choose "Stevens-Johnson" as your search term in the Rare Disease
Database.)
Therapies: Standard
Early treatment of infantile or childhood onset Lyelles Syndrome is
recommended because of the rapid progression of symptoms. Antibiotic (e.g.,
penicillin) drug therapy may be helpful for treatment of infection. Fluid
and electrolyte balance may need correction. Children should be watched
carefully to prevent them from touching peeled or blistered areas which could
possibly worsen the condition. Hospitalization and/or isolation may be
required to assure a sterile environment. Healing may rapidly follow
appropriate treatment.
Treatment of adult onset Lyelles Syndrome is usually similar to therapy
for severe burns. Contact with peeled skin surface should be minimal.
Hospitalization with isolation in a sterile environment to minimize infection
may be necessary. Severe loss of fluid and electrolytes may require
replacement on an ongoing basis to prevent dehydration. If the disorder is
caused by a drug reaction, systemic corticosteroids may be able to control
the reaction but do not seem to improve skin symptoms. Blood poisoning and
lung infections should be anticipated and treated promptly if they occur.
Other therapy is symptomatic and supportive.
Therapies: Investigational
Experimental plasmapheresis may be of benefit in cases of Lyelles Syndrome
caused by a severe reaction to drugs. This procedure is a method for
removing unwanted substances (toxins, metabolic substances and plasma parts)
from the blood. Blood is removed from the patient and blood cells are
separated from plasma. The patient's plasma is then replaced with other
human plasma and the blood is retransfused into the patient. This therapy is
still under investigation to analyze possible side effects and effectiveness.
More research is needed before plasmapheresis can be recommended for use in
all but the most severe cases of Lyelles Syndrome.
Research is underway in the areas of new wound healing drugs, antibiotics
and the inhibition of blister formation at dermatology research centers
listed in the Resources section of this report.
This disease entry is based upon medical information available through
October 1988. Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information on this disorder.
Resources
For more information on Lyelles Syndrome, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
The National Arthritis and Musculoskeletal and Skin Diseases Information
Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 495-4484
Dystrophic Epidermolysis Bullosa Research Association of America (DEBRA)
141 Fifth Ave., Suite 7-South
New York, NY 10010
(212) 995-2220
D.E.B.R.A.
7 Sandhurst Lodge
Wokingham Road
Crowthorne
Berkshire RG11 7QD
England
Tel: 0344 771961
CLINICAL FACILITIES
University of Washington School of Medicine
Department of Dermatology
St. Louis, MO 63110
(314) 362-5000
Rockefeller University
Department of Investigative Dermatology
1230 York Avenue
New York, NY 10021
(212) 570-8000
Children's Hospital
Department of Pediatric Dermatology
Dermatology Clinic
34th and Civic Center Blvd.
Philadelphia, PA 19104
(215) 596-9100
University of Pennsylvania
Dermatology Clinic
34th and Spruce Street
Philadelphia, PA 19104
(215) 622-2737
References
IMPROVED BURN CENTER SURVIVAL OF PATIENTS WITH TOXIC EPIDERMAL NECROLYSIS
MANAGED WITHOUT CORTICOSTEROIDS: P.H. Halebian, et al.; Ann Surg (November
1986, issue 204(5)). Pp. 503-512.
PLASMAPHERESIS IN SEVERE DRUG-INDUCED TOXIC EPIDERMAL NECROLYSIS: D.
Kamanabroo, et al.; Arch Dermatol (December 1985, issue 121(12)). Pp. 1548-
1549.