Antecedent Drug Exposure Aetiology and Management Protocols in Steven-Johnson Syndrome and Toxic Epidermal Necrolysis, A Hospital Based Prospective Study

Abstract

Present study suggest that drug induced cutaneous eruptions are common ranging from common nuisance rashes to rare life threatening diseases like SJS and TEN, SJS/TEN typically occur 1-3 weeks after initiation of therapy. Aromatic AED's, LTG, oxicam NSAID's, sulfasalazine and levofloxacin have a tremendous potential to trigger SCARS's. To ensure safe use of pharmaceutical agents and better treatment outcomes post marketing voluntary reporting of severe rare and unusual reactions remains inevitable.

Evaluation of the Factors Influencing Mortality in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Multicenter Study of 166 Patients

“…Due to the rarity of the disease, most studies on SJS-TEN are retrospective and involve a small number of patients. Only a few prospective studies analyzing the efficacy of specific immunomodulatory treatments have been conducted [ 4 , 6 , 17 ]. The absence of large randomized controlled trials prevents the establishment of a standard pharmacological treatment for SJS-TEN.…”

“…SCORTEN is the most commonly used scale for prognostication in SJS-TEN and its effectiveness as a tool has been confirmed in several studies [ 3 , 4 ]. The incidence of SJS and TEN is estimated to be 1.2–6 per million and 0.4–1.2 per million, respectively [ 5 , 6 ], with mortality rates varying but averaging 1–5% for SJS and 25–35% for TEN [ 5 , 6 ].…”

A Systematic Review of Efficacy and Safety of Monotherapy and Combination Therapy With Biologic for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

“…3,4 The annual incidence for SJS/TEN is approximately 1.2-6 and 0.4-1.2 per million people, respectively. 5,6 Both conditions affect women more frequently than men, with a ratio of 1.5:1; additionally, incidence increases with age. 6 The average mortality rate for SJS is approximately 1% to 5%; for TEN, mortality ranges from 25% to 35% but can be as high as 90%.…”

“…5,6 Both conditions affect women more frequently than men, with a ratio of 1.5:1; additionally, incidence increases with age. 6 The average mortality rate for SJS is approximately 1% to 5%; for TEN, mortality ranges from 25% to 35% but can be as high as 90%. [5][6][7][8] Initial symptoms of SJS/TEN precede cutaneous involvement by 1-3 days and can involve stinging eyes, fever, and odynophagia.…”

“…6 The average mortality rate for SJS is approximately 1% to 5%; for TEN, mortality ranges from 25% to 35% but can be as high as 90%. [5][6][7][8] Initial symptoms of SJS/TEN precede cutaneous involvement by 1-3 days and can involve stinging eyes, fever, and odynophagia. 7,8 Erythematous, dusky-red or purpuric skin lesions initially forms starting at the trunk, but adopts a characteristic grey hue as the disease progresses towards full-thickness necrosis.…”