Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study

Stocka-Łabno, Ewa; Gabzdyl, Natalia; Misiak-Gałązka, Magdalena; Pawłowska-Kisiel, Małgorzata; Łazowski, Tomasz; Rudnicka, Lidia

doi:10.7241/ourd.20164.104

Cited by 4 publications

(8 citation statements)

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“…1 Nekrolisis Epidermal terbagi menjadi beberapa tipe keparahan, yaitu Sindrom Stevens Johnson (SSJ) apabila yang terlibat kurang dari 10% area tubuh, 10% sampai 29% disebut SSJ overlap Nekrolisis Epidermal Toksik (NET), dan lebih dari 30% disebut NET. 2 Baik SSJ maupun NET merupakan penyakit yang mengancam jiwa dengan lesi awal berupa makula eritematosa, yang kemudian akan berkembang menjadi progresif berupa lesi lepuh yang kendur dan berlanjut menjadi pengelupasan epidermis. 1,2 Angka kejadian SSJ -NET 1,2 sampai 6 dan 0,4 sampai 1,2 per juta orang per tahun.…”

Section: Pendahuluanunclassified

“…2 Baik SSJ maupun NET merupakan penyakit yang mengancam jiwa dengan lesi awal berupa makula eritematosa, yang kemudian akan berkembang menjadi progresif berupa lesi lepuh yang kendur dan berlanjut menjadi pengelupasan epidermis. 1,2 Angka kejadian SSJ -NET 1,2 sampai 6 dan 0,4 sampai 1,2 per juta orang per tahun. 3 Pada penelitian Huang, dkk.…”

Section: Pendahuluanunclassified

“…melaporkan obat penyebab tersering adalah sulfonamid dan antikonvulsan (lamotrigin). 2 Pada penelitian ini obat penyebab tertinggi adalah antibiotik golongan sefalosporin dan anti-Inflamasi non-steroid parasetamol. Penelitian ini sama seperti penelitian Rini, dkk.…”

Section: Pendahuluanunclassified

“…melaporkan bahwa pasien SSJ -NET mempunyai penyakit komorbid, yaitu hipertensi. 2 Hal tersebut sama dengan penelitian ini, yaitu hipertensi, merupakan penyakit komorbid terbanyak pada pasien SSJ -NET di RSUD dr. Moewardi.…”

Section: Pendahuluanunclassified

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Profil Penggunaan Kortikosteroid Sistemik untuk Terapi Sindrom Stevens Johnson (SSJ) – Nekrolisis Eepidemal Toksik (NET) di Instalasi Rawat Inap RSUD DR. Moewardi Surakarta, Indonesia - Januari 2016 -Desember 2017

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<p>Latar belakang: Nekrolisis epidermal disebut Sindrom Stevens Johnson (SSJ) apabila yang terlibat kurang dari 10% dari area tubuh, 10% sampai 29% disebut SSJ overlap NET dan lebih dari 30% NET. Tujuan : Untuk mengetahui gambaran umum pasien SSJ-NET serta penggunaan kortikosteroid sistemik di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2016 – Desember 2017. Metode : Studi deskriptif retrospektif dengan populasi dan sampel penelitian pasien rawat inap di Instalasi Rawat Inap RSUD Dr. Moewardi, Surakarta, periode Januari 2016 – Desember 2017. Sampel menggunakan data sekunder dari status rekam medis di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta. Hasil: Total pasien 26 orang terutama berusia 46 – 55 tahun dan 56 – 65 tahun (23%). Laki-laki lebih banyak (57%). Diagnosis SSJ (61%) terbanyak dibandingkan SSJ overlap NET (19%) ataupun NET (19%). Hipertensi sebagai penyakit penyerta terbanyak (15%). Keterlibatan mukosa terbanyak pada mulut (88 %) dan penyebab terbanyak SSJ-NET melibatkan lebih dari satu macam obat (53%). Obat penyebab yang dicurigai terutama adalah antibiotik golongan sefalosporin dan parasetamol (23%). Rerata lama terapi deksametason adalah 10 hari dengan dosis rata-rata 25 mg per hari. Simpulan: Pengobatan kortikosteroid sistemik pada kasus SSJ – NET di RSUD dr. Moewardi Surakarta pada umumnya menghasilkan perbaikan klinis dengan rata-rata perawatan 10 hari dan dosis rata-rata deksametason 25 mg per hari.</p><p>Background: Epidermal Necrolysis is classified into several degree of severity based on the area of the body involved, below 10% is SJS, 10% - 29% is SJS overlap TEN and 30% is TEN. Objective: To provide general description of SJS-TEN patients and systemic corticosteroids therapy in Dr.Moewardi General Hospital Surakarta January 2016 - December 2017. Methods: A retrospective descriptive study on in-patients in Dr. Moewardi General Hospital Surakarta between January 2016 and December 2017. Results: Total sample was 26 patients, mostly male (57%) in 46 - 55 year-old and 56 - 65 year-old (23%). The most common diagnosis was SJS (61%) followed by SJS overlap TEN (19%) and TEN (19%). Hypertension was the most frequent comorbid disease (15%). Mostly affected was mouth mucosa (88%) and caused by mostly more than one drug (53%). Suspected causative drugs were mostly cephalosporin and paracetamol (23%). The average duration of dexamethason therapy was 10 days with an average dose 25 mg per day. Conclusion: SSJ - NET cases in Dr. Moewardi General Hospital Surakarta were mostly treated with systemic corticosteroids for an average of 10 days and an average dose of dexamethason 25 mg per day.</p>

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Section: Pendahuluanunclassified

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Profil Penggunaan Kortikosteroid Sistemik untuk Terapi Sindrom Stevens Johnson (SSJ) – Nekrolisis Eepidemal Toksik (NET) di Instalasi Rawat Inap RSUD DR. Moewardi Surakarta, Indonesia - Januari 2016 -Desember 2017

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“…No entanto, o quadro também pode ocorrer devido à hipersensibilidade a fatores como infecções por vírus, fungos e bactérias 4,5 . As duas patologias se diferem uma da outra pela área máxima afetada do corpo, de forma que quando o acometimento é inferior a 10% é considerado SSJ, entre 10 e 29% de acometimento corporal chama-se de síndrome de sobreposição SSJ/NET e acima de 30% de acometimento é considerado NET 6 . Ambas as síndromes são antecedidas por sintomas iniciais, comuns a outras doenças, que caracteriza uma fase denominada prodrômica, marcada por febre, mal-estar, mialgias, artralgias e tosse, com duração curta de no máximo duas semanas.…”

Section: Introductionunclassified

Necrólise Epidérmica Tóxica/Síndrome De Stevens Johnson: Como O Diagnóstico Precoce Pode Impactar No Prognóstico

Caminha¹,

Carvalho

Sousa³

et al. 2021

RECIMA21

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A Síndrome de Stevens-Johnson (SSJ) e a Necrólise Epidérmica Tóxica (NET) são reações agudas que atingem predominantemente pele e mucosas causadas principalmente pelo uso de medicamentos. São patologias raras, porém apresentam um alto índice de mortalidade que está intimamente associado ao diagnóstico tardio. Diante disso, objetivou-se avaliar de que forma o diagnóstico precoce da SSJ/NET pode impactar no prognóstico. Dessa forma foi realizada uma revisão sistemática da literatura, onde a pergunta norteadora foi definida a partir do acrônimo PICO. As buscas foram realizadas nas bases de dados PubMed e ScienceDirect entre fevereiro de 2020 e março de 2021, a partir dos descritores Necrólise epidérmica tóxica, Síndrome de Stevens-Johnson, diagnóstico precoce e prognóstico combinados pelos operadores booleanos AND e OR. Foram identificados 577 artigos e após análise inicial do título e resumo e uma segunda análise mais robusta a partir do texto completo e exclusão dos artigos duplicados, foram incluídos na revisão 24 artigos. Foi demonstrado em nossa busca que existem marcadores descobertos recentemente que podem auxiliar no diagnóstico como a dosagem de granulosina, TARC, IL-33 e IL-15. Em adição, conclui-se que o conhecimento sobre o tema é essencial para o diagnóstico rápido e eficiente e que a rapidez diagnóstica está intimamente correlacionada com a melhora no prognóstico do paciente.

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Tata Laksana Terintegrasi Sindrom Stevens-Johnson (SJS) dan Nekrolisis Epidermal Toksik (NET)

Yulisa,

Menaldi

2023

Cermin Dunia Kedokteran

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute life-threatening mucocutaneous reactions characterized by extensive epidermal necrosis and epidermal detachment. The incidence of SJS in Japan is 2.3 cases/100,000 people/per year. The mortality rate of SJS-TEN in Saudi Arabia is 1 per 10 cases (10%). SJS-TEN can be caused by drugs, idiopathic, infection, post-bone marrow transplant, immunization, radiotherapy, and genetics. The pathogenesis of SJS-TEN is suspected as a result of a cytotoxic reaction to keratinocyte cells which causes massive apoptosis. Clinical manifestation begins with prodromal symptoms followed by erythematous macular lesions and atypical target lesions that may confluence, then develop into bullous, oozing erosions with mucosal involvement. Vital sign observation is important to predict prognosis. A diagnostic procedure is necessary if another diagnosis is being considered. Management of SJS-TEN includes cessation of suspected drugs, early treatment such as fluid resuscitation, early nutrition, treatment and evaluation of eyes and skin lesions. Multiorgan involvement can occur in SJS-TEN so multidisciplinary management is needed for optimal therapy. Corticosteroids and cyclosporin A provide beneficial effects on SJS-TEN. SCORTEN is used to evaluate prognosis.

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Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study

Cited by 4 publications

References 10 publications

Profil Penggunaan Kortikosteroid Sistemik untuk Terapi Sindrom Stevens Johnson (SSJ) – Nekrolisis Eepidemal Toksik (NET) di Instalasi Rawat Inap RSUD DR. Moewardi Surakarta, Indonesia - Januari 2016 -Desember 2017

Profil Penggunaan Kortikosteroid Sistemik untuk Terapi Sindrom Stevens Johnson (SSJ) – Nekrolisis Eepidemal Toksik (NET) di Instalasi Rawat Inap RSUD DR. Moewardi Surakarta, Indonesia - Januari 2016 -Desember 2017

Necrólise Epidérmica Tóxica/Síndrome De Stevens Johnson: Como O Diagnóstico Precoce Pode Impactar No Prognóstico

Tata Laksana Terintegrasi Sindrom Stevens-Johnson (SJS) dan Nekrolisis Epidermal Toksik (NET)

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