"Thermoregulation in SJS/TEN Patients" by Erin M. Harper, Elizabeth A. Gideon et al.
  •  
  •  
 

Abstract

Stevens-Johnson Syndrome (SJS) is a severe disorder that is often caused by a rare reaction to medication that results in widespread blistering and peeling of skin and mucous membranes. This condition can progress to Toxic Epidermal Necrolysis (TEN) if the affected region covers more than 30% of the patient’s body. After healing, histological assessments of the SJS/TEN affected areas suggest abnormal sweat ducts that may impair thermoregulation. Consistent with that observation, these patients also report heat intolerance which may be due to impaired thermoregulation. Skin blood flow and sweating are two primary mechanisms that contribute to thermoregulation. Thus, there is a clear need to identify the effects of SJS/TEN on skin blood flow and sweating responses to heat stress in the affected areas. PURPOSE: We tested the hypothesis that skin blood flow and sweating responses to passive heat stress will be blunted in the affected area of recovered SJS/TEN patients. METHODS: Recovered SJS/TEN patients who were otherwise healthy participated in one experimental visit. Participants were heated by perfusing hot-water (~50°C) through a tube-lined suit until voluntary withdrawal (i.e., thermal tolerance) or until core body temperature was increased by 1°C. We measured skin blood flow (via laser-Doppler flowmetry) and local sweat rate (via ventilated capsule technique) from SJS/TEN affected and non-affected areas (not covered by the water-perfused suit) at rest and following heat-stress. Additionally, we measured core body temperature (via ingestible telemetric pill), heart rate (via electrocardiogram), and blood pressure (via automated auscultation of the brachial artery) during the experimental visit. RESULTS: Five participants (4 females, 1 male age: 29 ± 6 years) with a previous SJS/TEN diagnosis (4.5± 2.6 years ago) completed the study. Core body temperature increased by 0.85 ± 0.13°C from baseline to end-heating. The change in skin blood flow from baseline to end heating was not different (p=0.38) between SJS/TEN affected (∆156 ± 168 p.u.) and non-affected (∆145 ± 145 p.u.) areas. Additionally, the change in local sweat rate from baseline to end heating was not different (p= 0.141) between SJS/TEN affected (∆1.03 ± 0.20 mg/cm2/min) and non-affected (∆0.76 ± 0.27 mg/cm2/min) areas. CONCLUSION: Based on the obtained preliminary data, the thermoregulatory responses to passive heat stress (i.e. skin blood flow and local sweat rate) do not appear to be altered on SJS/TEN affected areas.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.