G S Gottschlich

Publications (2)1.15 Total impact

• Article: [Treatment of toxic epidermal necrolysis. Experience with 9 patients with consideration of intravenous immunoglobulin].

  P Spornraft-Ragaller, H Theilen, G S Gottschlich, M Ragaller
  [show abstract] [hide abstract]
  ABSTRACT: Toxic epidermal necrolysis (TEN) is the maximal variant of severe bullous drug reactions with a high mortality rate of 30-40%. Treatment should be interdisciplinary and is best provided in an intensive care setting. Since no specific therapy has been established, supportive intensive care and topical treatment are of crucial importance. Between 1995 and 2005, nine patients with TEN were treated in the anesthesiology intensive care unit in cooperation with dermatology in the University Hospital of Dresden. All patients initially received corticosteroids and five patients were additionally treated with intravenous immunoglobulins (IVIG). The overall mortality of 33% was underestimated by the SAPS II-Score, whereas it was overestimated by the TEN-specific SCORTEN. In more severely affected patients, other scoring systems in addition to SCORTEN should be used for prediction of prognosis and evaluation of therapy. The mortality rate of our IVIG treated patients was 20% vs. 50% compared to the non-IVIG-group. However, due to the small number of patients and contradictory results in the literature, IVIG cannot be generally recommended for the treatment of TEN, but should be considered in early stages of the disease.
  Der Hautarzt 04/2006; 57(3):185-6, 188-90, 192-4. · 0.58 Impact Factor
• Article: Behandlung der toxischen epidermalen Nekrolyse

  P. Spornraft-Ragaller, H. Theilen, G. S. Gottschlich, M. Ragaller
  [show abstract] [hide abstract]
  ABSTRACT: Die toxische epidermale Nekrolyse (TEN) ist als Maximalvariante schwerer bullser Arzneimittelreaktionen durch eine hohe Mortalittsrate von 30–40% gekennzeichnet. Die Behandlung ist eine interdisziplinre Aufgabe und sollte in einer hierfr ausgestatteten Intensiveinheit erfolgen. Bisher existiert keine spezifische Therapie, sodass der supportiven intensivmedizinischen Therapie und der Lokalbehandlung besondere Bedeutung zukommen. Von 1995–2005 wurden 9Patienten mit einer TEN auf der ansthesiologischen Intensivstation des Universittsklinikums Dresden in Kooperation mit der Klinik fr Dermatologie betreut. Alle Patienten erhielten initial Steroide und 5Patienten zustzlich intravense Immunglobuline (IVIG). Die Mortalittsrate von insgesamt 33% wurde mit der nach dem SAPS-II-Score ermittelten Prognose eher unterschtzt, mittels eines spezifischen Scores (SCORTEN) jedoch deutlich berschtzt. Bei schwerer betroffenen Patienten sollten daher auch andere intensivmedizinische Scores zur Ermittlung der Prognose und des Erfolgs therapeutischer Manahmen herangezogen werden. Die Mortalitt bei unseren mit IVIG behandelten Patienten betrug 20 vs. 50% in der Gruppe ohne IVIG. Obwohl aufgrund der uneinheitlichen Datenlage eine generelle Empfehlung zur Anwendung von IVIG bei TEN nicht gegeben werden kann, sollte nach unseren Erfahrungen die Indikation von IVIG frhzeitig erwogen werden.Toxic epidermal necrolysis (TEN) is the maximal variant of severe bullous drug reactions with a high mortality rate of 30–40%. Treatment should be interdisciplinary and is best provided in an intensive care setting. Since no specific therapy has been established, supportive intensive care and topical treatment are of crucial importance. Between 1995 and 2005, nine patients with TEN were treated in the anesthesiology intensive care unit in cooperation with dermatology in the University Hospital of Dresden. All patients initially received corticosteroids and five patients were additionally treated with intravenous immunoglobulins (IVIG). The overall mortality of 33% was underestimated by the SAPS II-Score, whereas it was overestimated by the TEN-specific SCORTEN. In more severely affected patients, other scoring systems in addition to SCORTEN should be used for prediction of prognosis and evaluation of therapy. The mortality rate of our IVIG treated patients was 20% vs. 50% compared to the non-IVIG-group. However, due to the small number of patients and contradictory results in the literature, IVIG cannot be generally recommended for the treatment of TEN, but should be considered in early stages of the disease.
  Der Hautarzt 02/2006; 57(3):185-194. · 0.58 Impact Factor