Template:Flatulence

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Template:Flatuelnce Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

_NOTOC_ Flatuelnce

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

_NOTOC_ Flatulence

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Overview

Flatulence is the presence of a mixture of gases known as flatus in the digestive tract of mammals expelled from the rectum. It is more commonly known as 'farting', 'passing gas', or 'passing wind' (UK).


References


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Pathophysiology

Microscopically, TEN causes cell death throughout the epidermis. Keratinocytes, which are the cells found lower in the dermis, specialize in holding the skin cells together, undergo necrosis (uncontrolled cell death).

Causes

Toxic epidermal necrolysis is a rare and usually severe adverse reaction to certain drugs. History of medication use exists in over 95% of patients with TEN. The drugs most often implicated in TEN are antibiotics such as sulfonamides, nonsteroidal anti-inflammatory drugs, allopurinol, antiretroviral drugs, corticosteroids andanticonvulsants such as phenobarbital, phenytoin, carbamazepine, and valproic acid. The condition might also result from immunizations, infection with agents such as Mycoplasma pneumoniae or herpes virus and transplants of bone marrow or organs.

Epidemiology and Demographics

The incidence is between 0.4 and 1.2 cases per 100,000 each year.

Natural History, Complications and Prognosis

The mortality for toxic epidermal necrolysis is 30-40%.[1] Loss of the skin leaves patients vulnerable to infections from fungi and bacteria, and can result in septicemia, the leading cause of death in the disease.[1] Death is caused either by infection or by respiratory distress which is either due to pneumonia or damage to the linings of the airway. Microscopic analysis of tissue (especially the degree of dermal mononuclear inflammation and the degree of inflammation in general) can play a role in determining the prognosis of individual cases.[2]

Diagnosis

Laboratory Findings

Sometimes, however, examination of affected tissue under the microscope may be needed to distinguish it between other entities such as staphylococcal scalded skin syndrome. Typical histological criteria of TEN include mild infiltrate of lymphocytes which may obscure the dermoepidermal junction and prominent cell death with basal vacuolar change and individual cell necrosis.[3]

References

  1. 1.0 1.1 Garra, GP (2007). "Toxic Epidermal Necrolysis". Emedicine.com. Retrieved on December 13, 2007.
  2. Quinn AM; et al. (2005). "Uncovering histological criteria with prognostic significance in toxic epidermal necrolysis". Arch Dermatol. 141 (6): 683–7. PMID 15967913.
  3. Pereira FA, Mudgil AV, Rosmarin DM (2007). "flatuelnce". J Am Acad Dermatol. 56 (2): 181–200. PMID 17224365.


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