OBJECTIVE: To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis. METHODS: Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate sequelae and their effects on sexual activity. Examination and surgical treatment were proposed to patients with symptomatic sequelae. RESULTS: Twenty-eight of the 40 patients reported genital lesions during the acute phase of toxic epidermal necrolysis. No specific treatment was carried out during the acute period. Sequelae were observed in five cases, of which three involved the lower genital tract and two the vulva exclusively. The two patients with exclusive vulval involvement did not attempt any sexual activity. The other three patients with both vulval and vaginal lesions were unable to have normal sexual intercourse. Two of the three patients were treated surgically. One patient succeeded in having intercourse, but surgery failed to relieve dyspareunia. CONCLUSION: Genital involvement is frequent during toxic epidermal necrolysis but rarely leads to symptomatic sequelae. Surgery for synechiae is sometimes necessary to recover sexual activity because the vulvovaginal canal is stenotic. Because of the partial effect on pain relief after surgery, a preventive approach should be tried.
OBJECTIVE: To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis. METHODS: Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate sequelae and their effects on sexual activity. Examination and surgical treatment were proposed to patients with symptomatic sequelae. RESULTS: Twenty-eight of the 40 patients reported genital lesions during the acute phase of toxic epidermal necrolysis. No specific treatment was carried out during the acute period. Sequelae were observed in five cases, of which three involved the lower genital tract and two the vulva exclusively. The two patients with exclusive vulval involvement did not attempt any sexual activity. The other three patients with both vulval and vaginal lesions were unable to have normal sexual intercourse. Two of the three patients were treated surgically. One patient succeeded in having intercourse, but surgery failed to relieve dyspareunia. CONCLUSION: Genital involvement is frequent during toxic epidermal necrolysis but rarely leads to symptomatic sequelae. Surgery for synechiae is sometimes necessary to recover sexual activity because the vulvovaginal canal is stenotic. Because of the partial effect on pain relief after surgery, a preventive approach should be tried.
Authors: Wan-Chun Chang; Riichiro Abe; Paul Anderson; Wanpen Anderson; Michael R Ardern-Jones; Thomas M Beachkofsky; Teresa Bellón; Agnieszka K Biala; Charles Bouchard; Gianpiero L Cavalleri; Nicole Chapman; James Chodosh; Hyon K Choi; Ricardo R Cibotti; Sherrie J Divito; Karen Dewar; Ulrike Dehaeck; Mahyar Etminan; Diane Forbes; Esther Fuchs; Jennifer L Goldman; James H Holmes; Elyse A Hope; Shuen-Iu Hung; Chia-Ling Hsieh; Alfonso Iovieno; Julienne Jagdeo; Mee Kum Kim; David M Koelle; Mario E Lacouture; Sophie Le Pallec; Rannakoe J Lehloenya; Robyn Lim; Angie Lowe; Jean McCawley; Julie McCawley; Robert G Micheletti; Maja Mockenhaupt; Katie Niemeyer; Michael A Norcross; Douglas Oboh; Cristina Olteanu; Helena B Pasieka; Jonathan Peter; Munir Pirmohamed; Michael Rieder; Hajirah N Saeed; Neil H Shear; Christine Shieh; Sabine Straus; Chonlaphat Sukasem; Cynthia Sung; Jason A Trubiano; Sheng-Ying Tsou; Mayumi Ueta; Simona Volpi; Chen Wan; Hongsheng Wang; Zhao-Qing Wang; Jessica Weintraub; Cindy Whale; Lisa M Wheatley; Sonia Whyte-Croasdaile; Kristina B Williams; Galen Wright; Sonia N Yeung; Li Zhou; Wen-Hung Chung; Elizabeth J Phillips; Bruce C Carleton Journal: J Dermatol Sci Date: 2020-03-07 Impact factor: 4.563
Authors: Katie D White; Riichiro Abe; Michael Ardern-Jones; Thomas Beachkofsky; Charles Bouchard; Bruce Carleton; James Chodosh; Ricardo Cibotti; Robert Davis; Joshua C Denny; Roni P Dodiuk-Gad; Elizabeth N Ergen; Jennifer L Goldman; James H Holmes; Shuen-Iu Hung; Mario E Lacouture; Rannakoe J Lehloenya; Simon Mallal; Teri A Manolio; Robert G Micheletti; Caroline M Mitchell; Maja Mockenhaupt; David A Ostrov; Rebecca Pavlos; Munir Pirmohamed; Elena Pope; Alec Redwood; Misha Rosenbach; Michael D Rosenblum; Jean-Claude Roujeau; Arturo P Saavedra; Hajirah N Saeed; Jeffery P Struewing; Hirohiko Sueki; Chonlaphat Sukasem; Cynthia Sung; Jason A Trubiano; Jessica Weintraub; Lisa M Wheatley; Kristina B Williams; Brandon Worley; Wen-Hung Chung; Neil H Shear; Elizabeth J Phillips Journal: J Allergy Clin Immunol Pract Date: 2018 Jan - Feb