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Record W4401566375 · doi:10.1093/bjd/ljae321

Recent progress in Stevens–Johnson syndrome/toxic epidermal necrolysis: diagnostic criteria, pathogenesis and treatment

2024· review· en· W4401566375 on OpenAlex
Natsumi Hama, Shigeki Aoki, Chun‐Bing Chen, Akito Hasegawa, Youichi Ogawa, Marc Vocanson, Hideo Asada, Chia‐Yu Chu, Cheng‐Che E. Lan, Roni P. Dodiuk‐Gad, Toshiharu Fujiyama, Tyng‐Shiuan Hsieh, Kousei Ito, Elina Jerschow, Yoshiko Mizukawa, Saeko Nakajima, Kazutoshi Nakamura, Jean‐François Nicolas, Takashi Satoh, Tatsuo Shiohara, Hayato Takahashi, Mikiko Tohyama, Takahiro Ueda, Katsuaki Ura, Hideaki Watanabe, Yukie Yamaguchi, Thierry M. Nordmann, Wen-Hung Chung, Dean J. Naisbitt, Carlo Pincelli, Werner J. Pichler, Lars E. French, Elizabeth Phillips, Riichiro Abe

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueBritish Journal of Dermatology · 2024
Typereview
Languageen
FieldMedicine
TopicDrug-Induced Adverse Reactions
Canadian institutionsUniversity of Toronto
FundersMinistry of Health, Labour and WelfareJapan Agency for Medical Research and Development
KeywordsToxic epidermal necrolysisMedicineMucocutaneous zoneDiseaseImmunologyDrug developmentDrugIntensive care medicineDermatologyPathologyPharmacology

Abstract

fetched live from OpenAlex

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent a severe spectrum of rare mucocutaneous reactions that are primarily drug-induced and characterized by significant morbidity and mortality. These conditions manifest in extensive skin detachment, distinguishing them from other generalized skin eruptions. The rarity and severity of SJS/TEN underscore the importance of accurate diagnostic criteria and effective treatments, which are currently lacking consensus. This review proposes new diagnostic criteria to improve specificity and global applicability. Recent advances in understanding the immunopathogenesis of SJS/TEN are explored, emphasizing the role of drug-specific T-cell responses and human leucocyte antigen polymorphisms in disease onset. The review also addresses current therapeutic approaches, including controversies surrounding the use of immunosuppressive agents and the emerging role of tumour necrosis factor-α inhibitors. Novel therapeutic strategies targeting specific pathogenic mechanisms, such as necroptosis and specific immune cell pathways, are discussed. Furthermore, the development of new drugs based on these insights, including targeted monoclonal antibodies and inhibitors, are examined. The review concludes by advocating for more robust and coordinated efforts across multidisciplinary medical fields to develop effective treatments and diagnostic tools for SJS/TEN, with the aim of improving patient outcomes and understanding the disease and its mechanisms.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.774
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0040.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.040
GPT teacher head0.346
Teacher spread0.306 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it