Kenneth Kee

Toxic Epidermal Necrolysis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions (eBook, ePUB)

• Format: ePub

Produktbeschreibung

>30% of the total body surface area SJS is a less serious presentation affecting mainly the lips, eyes and genital mucosa. People with 10-30% skin loss are categorized as "overlap". TEN is more often observed in people who have a specific genetic make-up (genotype) that leads to slow metabolizing of certain classes of drugs, or those who have HIV or are immune suppressed. There is the belief that an immune complex-mediated hypersensitivity reaction happens because of the presence of toxic drug metabolites which collect in the skin. This reaction leads to the damage of keratinocytes. Specifically, cytotoxic T lymphocytes produce keratinocyte damage and subsequent necrosis, mediated by granzyme B. Cytotoxic molecules such as FasL and granulysin have been indicated as causing the widespread keratinocyte apoptosis. More than 200 medicines have been linked with TEN, mostly: 1.Sulfonamides. 2.Ampicillin. 3.Quinolones 4.Cefalosporins. 5.Anticonvulsants - phenobarbital, phenytoin, carbamazepine, lamotrigine and valproate. 6.Allopurinol. Symptoms: There is a prodromal stage normally persisting 2-3 days with fever, symptoms the same as upper respiratory tract infection, conjunctivitis, pharyngitis, pruritus, malaise, arthralgia and myalgia. Mucous membrane affliction happens early in 90% of cases and often goes before other symptoms The conjunctivae, buccal, nasal, pharyngeal, tracheobronchial, perineal, vaginal, urethral and anal mucosae may all be affected. Skin lesions first occur in the pre-sternal region and the face, palms, and soles of the feet. A gentle touch or rub can slough the skin off and it is very painful (Nikolsky's sign) Diagnosis: There is no specific laboratory test required to diagnose TEN. Rapid histological examination such as direct immunofluorescence analysis of a lesion skin biopsy is first in the diagnostic work-up of TEN, as it helps to exclude diseases similar to TEN Treatment The first step is to stop the medicine causing TEN. Following this, the treatment for TEN and SJS is mostly supportive care until the top layer of skin regenerates. Affected individuals are often sent to a burns or intensive care unit and treated as if they have suffered from very severe burns. 1.Fluid and electrolyte replacement 2.Infection control with antibiotics 3.Pain relief 4.Skin care such as the use of topical antiseptics and regular wound dressings 5.Special wound nursing care 6.Eye, mouth and lung care 7.Urinary catheterization 8.Oral hygiene Some cases have benefited from the use of immunoglobulins, immunosuppressive agents, systemic steroids or other biologic agents. Debridement of necrotic areas of skin may be needed. The exposed dermis needs protecting with skin grafting to prevent fluid and protein loss and infection. TABLE OF CONTENT Introduction Chapter 1 Toxic Epidermal Necrolysis Chapter 2 Causes Chapter 3 Symptoms...

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Produktdetails

• Verlag: Kenneth Kee
• Erscheinungstermin: 17. Juli 2018
• Englisch
• ISBN-13: 9780463902189
• Artikelnr.: 53275790

Autorenporträt

Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.
He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.
Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.
Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.
He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.
He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.
Even as he grew older, Dr. Kee continued to work actively in his clinic, although he eventually reduced his consultation hours.
Beyond his medical career, Dr. Kee is also an author.
He started writing about medical conditions in 2007, using blogs and other online platforms to share his knowledge with a broader audience.
Over time, he published various books, many of which provide simple and accessible guides to different health conditions.
His works include "A Family Doctor's Tale," "My Personal Singapore History," and numerous medical guides, available through platforms like Amazon.
His books often combine his personal experiences as a family doctor with insights into Singapore's healthcare system and history.
Dr. Kee has written extensively on health topics, contributing to both medical literature and general knowledge resources.

Dr. Kenneth Kee has written numerous books, primarily focused on health education and personal experiences as a family doctor. Some of his notable titles include:
"A Family Doctor's Tale"
This book is a blend of Dr. Kee's personal experiences and his reflections on being a family doctor in Singapore. It's a great choice if you're looking for a narrative that combines both medical knowledge and human stories.
"Specialized Medical Conditions"
Books like **"Congestive Heart Failure: Diagnosis and Treatment"** focus on specific conditions, offering in-dept...