Ocular involvement in Stevens-Johnson syndrome:treatment with amniotic membrane transplantation in the acute phase

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are both part of a spectrum of serious mucocutaneous disorders, most often caused by drugs, with a high morbidity and mortality. In the acute stage, serious skin and mucocutaneous lesions with painful blistering, erosions and systemic involvement present the main focus of attention. The severity of skin manifestations in the acute stage, however, does not necessarily correlate with that of the mucosal lesions. Most feared are long-term sequelae, especially chronic eye involvement, which can be highly disabling. Here, we illustrate the importance of daily evaluation, early recognition and treatment of eye involvement in the acute stage of SJS/TEN, even when skin manifestations and/or initial eye involvement are relatively mild. Timely performed amniotic membrane transplantation in the acute stage can limit irreversible damage, caused by chronic inflammation, and therefore prevent cicatrisation at a later stage.</p

Toxic Epidermal Necrolysis after Pemetrexed and Cisplatin for Non-Small Cell Lung Cancer in a Patient with Sharp Syndrome

Background: Pemetrexed is an antifolate drug approved for maintenance and second-line therapy, and, in combination with cisplatin, for first-line treatment of advanced nonsquamous non-small cell lung cancer. The side-effect profile includes fatigue, hematological and gastrointestinal toxicity, an increase in hepatic enzymes, sensory neuropathy, and pulmonary and cutaneous toxicity in various degrees. Case Report: We present the case of a 58-year-old woman with history of Sharp's syndrome and adenocarcinoma of the lung, who developed toxic epidermal necrolysis after the first cycle of pemetrexed, including erythema, bullae, extensive skin denudation, subsequent systemic inflammation and severe deterioration in general condition. The generalized skin lesions occurred primarily in the previous radiation field and responded to immunosuppressive treatment with prednisone. Conclusion: Although skin toxicity is a well-known side effect of pemetrexed, severe skin reactions after pemetrexed administration are rare. Caution should be applied in cases in which pemetrexed is given subsequent to radiation therapy, especially in patients with pre-existing skin diseases

Impact of W Events and Dust on JET-ILW Operation

ABSTRACT The occurrence of transient impurity events (TIE) leading to intense radiation spikes in JET plasma discharges has been studied since the installation of the ITER-like Wall (ILW). To generate the observed average increase in radiated power of 1.5MW, a 100µm-radius sphere of solid W dust would be required. The drop in plasma energy caused by W-TIEs is fully recovered in 90% of all cases, only 1% inducing a longer term loss in plasma energy which sometimes leads to the shutdown of plasma operation. TIEs are correlated with disruptions and with measurements of the dust mobilized by disruptions using the high resolution Thomson scattering (HRTS) diagnostic. The dust characteristics giving rise to TIEs have been studied using the dust transport code DTOKS and the 1D impurity transport code STRAH