How is Lyell's syndrome treated?

Lyell's syndrome, also known as toxic epidermal necrolysis, is a potentially life-threatening dermatological disorder characterized by widespread erythema, necrosis, and desquamation of the epidermis and dermis. mucous membrane, leading the epidermis out of the dermis at the dermal-mucosal junction.

Lyell's syndrome is usually a severe immune response that is usually caused by medication. The syndrome begins 1 to 3 weeks after starting the drug with symptoms such as:
Fever, headache, Cough, keratoconjunctivitis (inflammation of the conjunctiva and cornea in the eye) Body aches. The red rash is flat on the face, neck, and trunk and spreads to the rest of the body. The red rashes gradually form blisters. Lyell syndrome is when more than 30% of the body's skin surface is shed, causing pain, fatigue, chills, and fever. In some people, hair and nails fall out. Palms and soles of the feet may be affected.
Sores appear on the mucous membranes of the mouth, throat, anus, genitals and eyes. Damage to the lining of the mouth makes eating difficult and closing the mouth can be painful, so the person may drool. The eye can become very painful, swollen, the cornea scarred, and vision changes. Sometimes the mucous membranes of the digestive and respiratory tracts are also affected leading to diarrhea and cough, pneumonia and difficulty breathing.
Skin loss in Lyell syndrome is similar to severe and life-threatening burns. The person is exhausted and may not be able to eat or open their eyes. People with this disorder are highly susceptible to organ failure, are at high risk for infection at sites of damaged tissue, and exposure due to skin loss.

People with Lyell's syndrome are hospitalized and treated in a burn center or intensive care unit. The mainstay of treatment consists of cyclosporine, plasma exchange or immunoglobulins.
The doctor will base on a number of factors as follows to plan treatment:
The patient's age, overall health and medical history Economic condition The patient's tolerance to the drug, skill Treatment technique Patient wishes or preferences Any drug suspected of causing Lyell's Syndrome should be discontinued immediately. Patients should be treated in a burn center or intensive care unit and given careful care to avoid infection. With good care and treatment, the skin will regrow on its own and, unlike burns, patients with Lyell syndrome do not need a skin graft. Fluids and salts lost through damaged skin are replenished by intravenous infusion.

2.1 Use Cyclosporine Use Cyclosporine to reduce blistering and peeling, thereby increasing the patient's survival. Cyclosporin belongs to the group of immunosuppressive drugs widely used in the medical field in countries around the world. Cyclosporin works by slowing down the immune system to minimize damage to joints, skin, or transplants. In addition, some doctors believe that giving large doses of corticosteroids for the first few days is beneficial, but they are not recommended because they can increase the likelihood of serious infections. If signs of an infection develop, doctors will prescribe antibiotics immediately.
2.2 Plasma exchange In this technique, the patient's blood is removed and the plasma is separated from the blood cells and platelets. In addition, this technique also removes certain substances in the blood such as drugs and antibodies (immune system proteins) that are suspected of causing Lyell's syndrome.
Doctors may give intravenous immunoglobulins to treat Lyell's syndrome to help the body prevent further damage by blocking antibodies.
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