EuroSCAR 2008-allopurinol "Results of this multinational study (EuroSCAR) revealed that allopurinol is the drug most commonly associated with SJS orTEN.The incidence of allopurinol-associatedSJS orTENhas increasedpossibly because of increased use and dosages of this drug." ( J Am Acad Dermatol 2008;58:25-32.) See Abstract.

Allopurinol may express its therapeutic effects via its antioxidation or anti-inflammatory properties, or its ability to improve vascular function.

Title:Allopurinol in dermatology.

Published: 2010 in American journal of clinical dermatology Demographics:TaiwanConditions:Dermatitis Medicamentosa

Lyell's Syndrome Heart Failure Psoriasis Sarcoidosis Dermatoses Stevens-Johnson Syndrome HyperuricemiaTreatments:Allopurinol (Caplenal)Therapeutic Off-Label UseInstitution:National Taiwan University HospitalExperts:Tsai, Tsen-FangYeh, Ting-Yu Full Abstract

Allopurinol is traditionally considered to be a drug for hyperuricemia only, but the recent demonstration of its efficacy in congestive heart failure has spurred renewed interest in its application in other clinical specialties.

In dermatology, allopurinol is best known for its severe cutaneous adverse reactions. Recent genomic studies conducted in Taiwan have discovered useful HLA markers for determining

the susceptibility of Stevens-Johnson syndrome

and toxic epidermal necrolysis associated with allopurinol.

Allopurinol has also been used in a number of dermatologic disorders including acquired reactive perforating collagenosis, sarcoidosis, psoriasis and granulomas caused by methacrylate microspheres, silicon and tattoos.

Allopurinol may express its therapeutic effects via its antioxidation or anti-inflammatory properties, or its ability to improve vascular function.

Outcome: Ocular manifestations occur in a high proportion of patients with
EM / SJS /TEN.

Title:Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis: acute ocular manifestations, causes, and management.

Published: 2007 Feb

in Cornea Patients:207

Demographics:Adult, 19 to 44 Aged, 65 to 79 Aged, 80 and olde rChild, 6 to 12 Preschool Child, 2 to 5 Infant, 1 to 23 months Newborn Infant, birth to 1 monthTaiwan Adolescent, 13 to 18 Middle Aged, 45 to 64

Conditions:Acute Disease

Lyell's Syndrome

Erythema Multiforme

Eye Disease

Stevens-Johnson Syndrome

Treatments:Allopurinol (Caplenal) Biopsy Carbamazepine (Epimaz)TreatmentsInstitution:National Cheng Kung UniversityExperts:Chang, Yi-ShengHo, Chung-LiangHsu, Chao-KaiHuang, Fu-ChinSheu, Hamm-MingTseng, Sung-Huei Full Abstract

Conditions Treatments Experts Symptoms Demographics

PURPOSE: To study the acute ocular/cutaneous manifestations, causes, and management of the erythema multiforme (EM) /Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) disease spectrum.

METHODS: We retrospectively reviewed the medical records of all EM/SJS/TEN patients hospitalized at National Cheng Kung University Hospital in Taiwan between 1988 and 2004.

Demographic data, medical/medication histories, ocular/mucocutaneous manifestations, management, sequelae, and recurrence were analyzed.

RESULTS: A total of 207 patients 2 months to 95 years of age were hospitalized with 213 episodes/attacks of EM/SJS/TEN.

Medications were the most common cause of any condition: for SJS, carbamazepine was most common;

for EM or TEN, allopurinol was most common.

In 128 of the 213 attacks (60.1%; 126 patients), ocular manifestations were documented during hospitalization, occurring more often in those with SJS (81.3%) or TEN (66.7%) compared with those with EM (22.7%; P < 0.01). The most frequent ocular treatments were topical steroids, topical antibiotics, and lubricants. Overall, 24 (18.8%) of 128 acute attacks in 126 patients were followed by ocular sequelae, mostly dry eye. Five (2.4%) of the 207 patients sustained a total of 6 recurrent attacks, in 3 cases because of the same medication.

CONCLUSIONS: Ocular manifestations occur in a high proportion of patients with EM /SJS /TEN. The most frequent causes were carbamazepine and allopurinol. A careful medication history should be obtained from these patients. Ophthalmic consultation, evaluation, and management are mandatory.