Nationwide Survey of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Children in the United States

Abstract

Although Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious, life-threatening reactions to drug therapies, no efforts have been made to investigate the comprehensive change in epidemiology with respect to age, sex, and race and ethnicity in children. The risk of death was 0.3% to 1.5%, and the highest hospitalization rates were in children 15 to 19 years of age, boys, and black children. The highest proportions of hospitalizations were children with very low household income, those with private insurance, and those treated at large urban teaching hospitals in the West. A significant winter-autumn predominance was observed.

Long‐term and multiple hospital readmissions after discharge for Stevens–Johnson syndrome and toxic epidermal necrolysis

“…Large, metropolitan hospitals may treat more complicated cases of SJS–TEN leading to higher readmission rates. Previous studies found increased hospitalization for SJS–TEN in children admitted to large, metropolitan teaching hospitals …”

“…Previous studies found increased hospitalization for SJS-TEN in children admitted to large, metropolitan teaching hospitals. 5 Together, these findings suggest the high occurrence of readmission among inpatients with SJS-TEN is secondary to both disease-specific sequelae and systemic comorbidities. Close follow-up care after hospital discharge may help prevent readmission.…”

“…4 Despite challenges in management and a significant burden of comorbidities in PN, there are limited studies examining healthcare utilization in this condition. 5 Herein we use a medical claims database from a large, ambulatory cohort to describe real-world healthcare utilization and economic burden in PN.…”

Delayed hypersensitivity to antiepileptic drugs in children

“…person-years which is higher than adults in some nationwide studies. [30][31][32][33][34] Despite an increased frequency of HRs to AEDs in childhood, recent studies showed that the risk of death with SJS/TEN is lower in children than in adults. 14,30,32,34 Given the above knowledge, the concomitant administration of AEDs should always be undertaken with caution and using a slower titration.…”

“…In addition, children who used a single AED had a lower frequency of HRs than those who used multiple AEDs; 3.8% vs 4.4%, respectively 5 . Moreover, the overall incidence rate of SJS/TEN among children was reported to be 5 to 7 cases per million person‐years which is higher than adults in some nationwide studies 30‐34 . Despite an increased frequency of HRs to AEDs in childhood, recent studies showed that the risk of death with SJS/TEN is lower in children than in adults 14,30,32,34 …”