The Effect of SJS/TEN on Skin Blood Flow and Sweating Responses During Heat Stress- Preliminary Data

Authors

Erin M. Harper, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital DallasFollow
Elizabeth A. Gideon, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital DallasFollow
Zachary J. McKenna, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital DallasFollow
Shivani Jain, Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USAFollow
Melissa M. Mauskar, Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USAFollow
Craig G. Crandall, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TXFollow

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.

Recommended Citation

Harper, Erin M.; Gideon, Elizabeth A.; McKenna, Zachary J.; Jain, Shivani; Mauskar, Melissa M.; and Crandall, Craig G. (2025) "The Effect of SJS/TEN on Skin Blood Flow and Sweating Responses During Heat Stress- Preliminary Data," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 17, Article 40.
Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss17/40