Differential Diagnostics of Toxic Epidermal Necrolysis (Lyell’s Syndrome) in ICU: Case Reports
Yu. V. Molochkova,
Zh. S. Philippovskaya,
А. G. Kupriyanova,
E. V. Mitina,
O. V. Karzanov,
T. E. Sukhova,
M. S. Petrova,
E. V. Chernyaeva https://doi.org/10.21292/2078-5658-2021-18-6-97-104
Abstract
Toxic epidermal necrolysis (TEN) is a critical life-threating condition developing as the total detachment of epidermidis and characterized by severe pathological reactions of all body systems. The current article describes two cases of TEN with similar clinical and laboratory signs. In one case the diagnosis of TEN was subsequently refused.
The objective: analysis of methods of clinical and differential diagnostics of conditions accompanied with massive epidermidis detachment in ICU patients.
Results. The immunomorphological evaluation of skin specimen obtained from the patient with a torpid form of TEN showed linear IgG fixation in the intercellular space of stratum basale, stratum spinosum and stratum granulosum and C3 fixation in the intercellular space of stratum basale.
Conclusion. The complex of anamnesis data and pathomorphological evaluation of skin are crucial for the diagnosis and treatment of patients with atypical TEN.
About the Authors
Yu. V. Molochkova
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Yulia V. Molochkova, Doctor of Medical Sciences, Associate Professor of Department of Dermatovenerology and Skin Cancer, Faculty for Medical Professional Development, Head of Dermatovenerology Department
61/2, Schepkina St., Moscow, 129110
Zh. S. Philippovskaya
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Zhanna S. Philippovskaya, Candidate of Medical Sciences, Head of Anesthesiology and Cardiac Intensive Care Department
61/2, Schepkina St., Moscow, 129110
А. G. Kupriyanova
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Anna G. Kupriyanova, Candidate of Medical Sciences, Leading Researcher of Morphological Diagnostics Unit, Department of Oncology
61/2, Schepkina St., Moscow, 129110
E. V. Mitina
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Elena V. Mitina, Anesthesiologist and Emergency Physician, Anesthesiology and Intensive Care Department 2
61/2, Schepkina St., Moscow, 129110
O. V. Karzanov
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Oleg V. Karzanov, Candidate of Medical Sciences, Senior Researcher of Department of Dermatovenerology and Skin Cancer, Faculty for Medical Professional Development
61/2, Schepkina St., Moscow, 129110
T. E. Sukhova
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Tatyana E. Sukhova, Doctor of Medical Sciences, Leading Researcher of Department of Dermatovenerology and Skin Cancer, Faculty for Medical Professional Development
61/2, Schepkina St., Moscow, 129110
M. S. Petrova
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Marina S. Petrova, Dermatovenerologist, Researcher of Department of Dermatovenerology and Skin Cancer, Faculty for Medical Professional Development
61/2, Schepkina St., Moscow, 129110
E. V. Chernyaeva
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Ekaterina V. Chernyaeva, Resident of Department of Dermatovenerology and Skin Cancer, Faculty for Medical Professional Development
61/2, Schepkina St., Moscow, 129110
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Review
For citations:
Molochkova Yu.V., Philippovskaya Zh.S., Kupriyanova А.G., Mitina E.V., Karzanov O.V., Sukhova T.E., Petrova M.S., Chernyaeva E.V. Differential Diagnostics of Toxic Epidermal Necrolysis (Lyell’s Syndrome) in ICU: Case Reports. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(6):97-104. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-6-97-104
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