Status of plasmapheresis for the treatment of toxic epidermal necrolysis in Japan.

This study describes the efficacy of plasmapheresis for the treatment of toxic epidermal necrolysis (TEN), as reported in Japan. TEN patients treated with plasmapheresis were collected from Japanese literature. The type of plasmapheresis, number of sessions, efficacy of plasmapheresis, and present outcome were examined. Forty-seven TEN patients treated with plasmapheresis have been reported in the literature: 19 men and 28 women with ages ranging from 1 to 96 years (mean 50.3 years). Twenty-five of these treatments included simple plasma exchange (PE), 13 included double filtration plasmapheresis (DFPP), and one included PE and DFPP. The number of plasmapheresis sessions ranged from 1 to 6 and the mean number of sessions was 3.1. The efficacy of plasmapheresis for the treatment of TEN was as follows: excellent, 30 cases; good, 8 cases; fair, 3 cases; no effect, 5 cases; and unknown, 1 case. The rate of effectiveness was 80.9%; eleven patients died; and the mortality rate was 23.4%. In summary, plasmapheresis, including both PE and DFPP, were found to be effective treatments for Japanese patients with TEN, who had been unresponsive to corticosteroids, and for those who show severe clinical manifestations.