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Granulysin skin game

Researchers in Taiwan have identified a cytotoxic protein, granulysin, that could be targeted to treat or diagnose Stevens-Johnson syndrome and toxic epidermal necrosis.1 The data suggest the protein is a central player in the skin cell necrosis seen in patients with these conditions.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) are cutaneous eruptions caused by adverse drug reactions and have a mortality rate of 10-50%.2 Mechanistically, both are considered variants in severity of the same condition: SJS is characterized by <10% skin detachment, TEN by >30% detachment and overlapping SJS and TEN by 10-30% detachment.3

The reactions have been linked to the use of many drugs, with most reports being related to anticonvulsants, antibiotics and NSAIDs.4 SJS risks contributed

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