Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience

Abstract

Aim: Stevens Johnson syndrome and toxic epidermal necrolysis are severe acute mucocutaneous diseases. In this study, we evaluated the clinical aspects of Steven Johnson syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap patients who admitted to our clinics in the last five years. Material and Methods: Eleven patients diagnosed as Stevens-Johnson syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome/toxic epidermal necrolysis overlap in Department of Pediatric Allergy in Uludağ University School of Medicine were included in this study. Clinical findings, laboratory tests and response to treatments were evaluated via electronic files. Results: Two of the patients had Stevens-Johnson syndrome, four had Stevens-Johnson syndrome/toxic epidermal necrolysis overlap, and five had toxic epidermal necrolysis. The median period for drug usage was 10 days (2-44 days). Herpes simpleks virus IgM antibody was detected two patients. The median healing time was 38 days 26-94 days). Maculopapular eruptions and oral mucositis were seen in all patients. Vesicul or bullae, epidermal detachment and ocular involvement in 10 of patients. Wound care, H1 antihistamine and methyl prednisolon were used in all patients, intravenous immunoglobulin were used in 7 patients and cyclosporine in 1 patient. Sequel lesions developed in 2 of the patients and there was no death. Conclusion: Anticonvulsants, antibiotics and non steroid anti-inflammatory drugs play a major role in the etiology of Stevens-Johnson syndrome and toxic epidermal necrolysis. Anticonvulsants are associated with severe disease. The patients with proper wound care and treatment with immunosuppressive drugs can be recovered without or with minimal sequelae. (Turk Pediatri Ars 2016; 51: 152-8)

A Comprehensive Assessment of Long-Term Complications in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

“…Control spirometry tests, laboratory tests, and psychometric tests were applied. Our group has previously published the acute phase findings, etiological factors, and treatment data of some patients included in our study [8].…”

Tools to improve the diagnosis and management of T-cell mediated adverse drug reactions

“…The majority of the data is extrapolated from small older studies. Some reports suggest that drug-induced SCARs are less prevalent in the pediatric population compared to an adult population (6)(7)(8)(9). A description of the main delayed drug related T-cell mediated hypersensitivity reactions is portrayed in Table 1 with an illustration of the immunopathogenesis and treatment options in Figure 2.…”