Okuläre Beteiligung bei Stevens-Johnson-Syndrom und Toxisch epidermaler Nekrolyse

Zusammenfassung

Das Stevens-Johnson-Syndrom (SJS) und die Toxisch epidermale Nekrolyse (TEN) stellen seltene schwere Reaktionen der Haut- und der Schleimhäute dar. Sie werden als eine Krankheitsentität verschieden schwerer Ausprägung angesehen und werden meist durch Arzneimittel ausgelöst, seltener durch Infekte. Okuläre Komplikationen entwickeln sich bei mehr als 50 % der Betroffenen und sie können unter Umständen ohne rechtzeitige ophthalmologische Intervention zur Erblindung führen. Der akute Befund, der ungewisse Verlauf sowie die extreme Variation und zeitliche Folge der Komplikationen von SJS und TEN erfordern eine interdisziplinäre Behandlung. Rechtzeitige Diagnosestellung und frühzeitige Einleitung einer oberflächenpflegenden anti-inflammatorischen Therapie sind von entscheidender Bedeutung für den weiteren Verlauf und können die Lebensqualität quoad visum erheblich verbessern. Dieser Beitrag soll dem besseren Verständnis dieser Reaktionsformen dienen und so zu einer Verbesserung der visuellen Rehabilitation und Lebensqualität der Patienten führen

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe reactions of skin and mucous membranes. They are considered as a single disease entity with differing severities and are mainly induced by drugs, less frequently by infections. In 50 % of the patients ocular complications occur, which can lead to blindness in the absence of immediate ophthalmological treatment. The acute pattern, the unpredictable course and extreme variations in the manifestation of complications require an interdisciplinary treatment. Early diagnosis and initiation of an intensive lubricating and anti-inflammatory surface care are of utmost importance for the best visual outcome. This article is intended to help ophthalmologists towards a better understanding and interpretation of clinical signs of these conditions with the goal to achieve substantial improvements in visual outcome and of course the patient’s quality of life

Schlüsselwörter

Kornea - Bindehaut - Pathologie - Stevens-Johnson-Syndrom - Toxisch epidermale Nekrolyse - okuläre Beteiligung

Key words

cornea - conjunctiva - pathology - Stevens-Johnson syndrome - toxic epidermal necrolysis - ocular manifestation

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