Séquelles cutanéomuqueuses et oculaires des SJS et de Lyell

Fellahi, A.; Zouhair, K.; Amraoui, A.; Benchikhi, H.

doi:10.1016/j.annder.2010.10.029

Cited by 13 publications

(7 citation statements)

References 14 publications

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“…Our study clearly revealed that 38% of SJS/TEN survivors suffer from long-term cutaneous complications such as diffuse dyschromic macules (38.0% of the patients), pruritis (20% of the patients), hypertrophic scars (2.8% of the patients), nail dystrophy (1.4% of the patients), and hair loss (1.4% of the patients). These frequencies are significantly lower than those reported by other authors which ranged from 72 to 77% [4, 5, 11]. The long average time of follow-up and the skin pigmentation of our patients (black skin) might explain the under-diagnosis of hyperchromic sequelae.…”

Section: Discussioncontrasting

confidence: 81%

“…Moreover, the hyperchromic scars reported in our series are related to the peculiarity of black skin which has the tendency to develop cheloids. At last, other long-term cutaneous complications like eruptive naevi, anetodermia, cutaneous calcifications, or increased sweating reported in other series [3, 4, 12, 13] were absent in our study.…”

Section: Discussioncontrasting

confidence: 63%

“…Our study also revealed that 36.6% of survivors of SJS/TEN had ocular sequelae, dominated by reduced visual acuity (14.1% of the patients), followed by symblepharon (12.7% of the patients), photophobia (12.7% of the patients), and dry eyes (9.9% of the patients). Dry eyes syndrome which is the main ocular long-term complication reported in literature [4, 5, 12–14] was found in 9.9% of our patients, probably not often researched. Ocular sequelae can go as far as blindness since 2.8% of our survivors of SJS/TEN had become blind.…”

Section: Discussionmentioning

confidence: 72%

“…This skin pigmentation might also explain the absence of photosensitivity cases and the fact that the sequelae were dyschromic in our series, contrary to the hyperchromic and hypochromic sequelae which were respectively reported in the studies of Fellahi and al. [4] and Sheridan and al. [11].…”

Section: Discussionmentioning

confidence: 99%

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Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo

Saka

Akakpo

Teclessou

et al. 2019

Dermatology Research and Practice

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Aim. The aim of this study was to assess ocular and mucocutaneous sequelae among SJS/TEN survivors and identify risk factors of ocular sequelae. Patients and Method. Late complications among SJS/TEN survivors were assessed using 2 methods: a retrospective assessment of medical records only or a retrospective assessment of medical records and physical examination of survivors who were contacted by phone. Results. Between January 1995 and December 2017, 177 cases of SJS/TEN (138 cases of SJS, 29 cases of TEN, and 10 cases SJS/TEN overlap) were admitted into two university hospitals of Lomé (Togo). There were 113 women and 64 men, with an average age of 31.7±13.0 years (range: 5 to 80 years). The most used drugs were antibacterial sulfonamides (35.6%) and nevirapine (24.3%). HIV serology was positive in 68 (59.1%) of the 115 patients tested. Sixty-four (52,5%) of the 122 patients, who had been examined by an ophthalmologist during the acute stage, had acute ocular involvement, which was mild in 27.9% of patients, moderate in 13.1%, and severe in 11.5%. We recorded 17 deaths (i.e., three cases of SJS, 12 of TEN, and two of SJS/TEN overlap), including 11 cases of HIV infected patients. Of the 160 SJS/TEN survivors, only 71 patients were assessed 6 months after hospital discharge. Among them, forty-three (60.6%) patients had sequelae. Concerning mucocutaneous sequelae, the main lesions were diffuse dyschromic macules (38.0% of patients) and ocular sequelae were dominated by decreased visual acuity (14.1% of patients). In multivariate analysis, exposure to sulfadoxine (odds adjusted ratio = 5.95; 95%CI= [1.36-31.35]) and moderate (adjusted odds ratio = 5.85; 95%CI = [1.23-31.81]) or severe (adjusted odds ratio = 48.30; 95%CI = [6.25-1063.66]) ocular involvement at acute stage were associated with ocular sequelae. Conclusion. Ocular and mucocutaneous sequelae are common in SJS/TEN survivors. Exposure to sulfadoxine and severity of acute ocular involvement are risk factors of ocular sequelae.

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Section: Discussioncontrasting

confidence: 81%

Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo

Saka

Akakpo

Teclessou

et al. 2019

Dermatology Research and Practice

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“…There also seems to be a relationship between severity of the disease and premature birth, likely attributed to foetal stress as a result of maternal disease. [ 9 ] However, it is unclear what percentage of maternal body surface area needs to be denuded for the risk to become significant.…”

Section: Introductionmentioning

confidence: 99%

Stevens Johnson Syndrome and Toxic Epidermal Necrolysis: Maternal and Foetal Outcomes in Twenty-Two Consecutive Pregnant HIV Infected Women

et al. 2015

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IntroductionStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) form a spectrum of a rare and life-threatening cutaneous drug reaction. SJS/TEN in pregnancy poses largely unknown risk factors and outcomes for both the mother and foetus compared to the general population.MethodsWe conducted a study of consecutive pregnant women admitted to single tertiary referral centre in South Africa with SJS/TEN over a 3 year period. They were all managed by the same medical team using the same protocols. We evaluated their underlying illnesses, offending drugs and the course of pregnancy and outcomes to determine factors influencing maternal and foetal outcomes.ResultsWe identified twenty-two women who developed SJS/TEN while pregnant, all of them HIV-infected. Their median age was 29 years. The majority 16/22 (73%) had SJS, the milder variant of the disease affecting < 10% body surface area. Nevirapine was the offending drug in 21/22 (95%) cases. All 22 of the mothers survived with 3/22 (14%) developing postpartum sepsis. Pregnancy outcomes were known in 18/22 women and 9/18 (50%) babies were delivered by caesarean section. There were 2 foetal deaths at 21 and 31 weeks respectively and both were associated with post-partum sepsis. Postnatal complications occurred in 5 cases, 3 involving the respiratory system and the other two being low birth weight deliveries. Eight placentae and one foetus were sent for histology and none showed macroscopic or microscopic features of SJS/TEN. On follow-up, only 12/20 children were tested for HIV at 6 weeks post-delivery and none of them were HIV-infected. All had received prophylactic ARVs including nevirapine.ConclusionsTEN, the severe form of the disease, was associated with poorer foetal outcomes. SJS/TEN-associated mortality is not increased in HIV-infected pregnant women. Maternal SJS/TEN does not seem to commonly manifest in the foetus.

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