000 02675cam a2200313 4500500
005 20250821140539.0
041 _afre
042 _adc
100 1 0 _aMinakawa, Fumika
_eauthor
700 1 0 _a Yanagida, Nozomi
_eauthor
700 1 0 _a Sugiyama, Seiko
_eauthor
700 1 0 _a Toi, Yoichiro
_eauthor
700 1 0 _a Urakami, Yosuke
_eauthor
700 1 0 _a Oka, Daigo
_eauthor
700 1 0 _a Tanaka, Ryo
_eauthor
700 1 0 _a Yamamoto, Takenobu
_eauthor
700 1 0 _a Aoyama, Yumi
_eauthor
245 0 0 _aDifferences in the management of toxic epidermal necrolysis related and unrelated to immune checkpoint inhibitors
260 _c2025.
500 _a8
520 _aBackgroundThere are currently no reliable biomarkers to predict the occurrence of severe complications and treatment response in patients with toxic epidermal necrolysis (TEN). Immune checkpoint inhibitor-related TEN (irTEN) is much rarer than typical TEN, but mortality rates associated with irTEN are much higher than those for TEN. TEN and irTEN should therefore be managed in a different manner.ObjectivesTo investigate biomarkers that could be used to predict outcomes and therapeutic efficacy associated with irTEN and TEN.Materials & MethodsSeven patients with TEN and two patients with irTEN were included in the study. The seven patients with TEN were treated with varying combinations and sequences of high-dose corticosteroids, intravenous immunoglobulin, pulse corticosteroids and plasma pheresis.ResultsFour of the seven TEN patients developed severe complications, and one patient eventually died due to cytomegalovirus disease. We found that, for TEN, a high neutrophil-to-lymphocyte ratio (NLR) at baseline was associated later onset of severe complications, and a subsequent decrease in NLR after starting immunosuppressive therapy was associated with a beneficial treatment response. In contrast, the opposite was found for the two irTEN patients; a low NLR at baseline and an increase in NLR after starting treatment were associated with poor outcome and a beneficial treatment response, respectively.ConclusionThe NLR may be differentially used as a practical and cost-efficient biomarker to predict treatment response and disease outcomes in patients with TEN and irTEN.
690 _abiomarker
690 _aimmune checkpoint inhibitor
690 _aneutrophil-to-lymphocyte ratio
690 _atoxic epidermal necrolysis
690 _atreatment
786 0 _nEuropean Journal of Dermatology | 35 | 3 | 2025-08-04 | p. 224-229 | 1167-1122
856 4 1 _uhttps://shs.cairn.info/revue-european-journal-of-dermatology-2025-4-page-224?lang=en&redirect-ssocas=7080
999 _c1413572
_d1413572