Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Abstract

Background: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening, severe drug reactions. Randomized studies on these diseases are difficult to perform. Aims and Objectives: The purpose of this study was to summarize the demographic and clinical characteristics of patients with SJS and TEN in a tertiary hospital in Turkey. Materials and Methods: We evaluated the records of 33 patients with SJS and TEN who were followed in our clinic or examined between January 2008 and June 2019, retrospectively. Age, sex, time of admission to hospital, causative drug, presence of concomitant disease, skin findings, mucosal involvement, the severity-of-illness score for TEN, the medication used, antibiotic use, transfer to intensive care, development of complications, and death or discharge status were noted. Results: Of the 33 patients, 11 (33.3%) had SJS, 3 (9.1%) had SJS/TEN overlap, and 19 (57.6%) had TEN. The majority (60.6%) of the patients were female. Nineteen (57.6%) patients had one, and 13 (39.4%) had more than one suspected drug exposure in their history. The most commonly suspected drugs were antibiotics. Twelve (36.4%) patients had intensive care unit hospitalization. Ten (30.3%) patients died. Conclusion: The demographic data of our study were consistent with the literature. Similar to the literature, antibiotics were the most common reaction-causing drugs. However, antiepileptic drugs, which were more frequently reported in other studies, were identified as suspicious in only one patient. We believe that our study will contribute to the determination of characteristics of this rare disease with real-life data.

RDW-SD and PCT Are Potential Prognostic Factors for In-hospital Death in Patients With Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

“…There is a certain gender difference in SJS/TEN patients. Most previous studies showed a female predominance, 14 21 consistent with the present study, but there were still a few literatures to show that males are more susceptible than females. 22 Some researchers found that female patients had worse prognosis and higher mortality, 23 but we did not find a correlation between gender and death.…”

Síndrome Stevens-Johnson e Necrólise Epidérmica Tóxica: Atualizações e Associações Farmacológicas

“…Dentre as associações de fármacos com SSJ/NET, as evidências apontam, de modo geral, os antibióticos como causadores mais comuns, mas, além deles, estão em destaque alopurinol (inibidor enzimático), carbamazepina (anticonvulsivante), lamotrigina (anticonvulsivante), AINEs com oxicam, nevirapina (antirretroviral) e sulfassalazina (antiinflamatório) (Acar et al, 2022). Geralmente, o intervalo entre exposição medicamentosa e início da SSJ/NET é de 4 a 28 dias e inclui lesões cutâneas vistas como máculas vermelho-escuras e sintomas prodrômicos, como dor de garganta e queimação nos olhos; além disso, a dor na pele é um achado de alerta para necrose epidérmica (Acar et al, 2022).…”

Pembrolizumab-induced toxic epidermal necrolysis: A rare cause of severe adverse drug reaction

“…Stevens-Johnson syndrome/toxic epidermal necrolysis is the most dreaded adverse cutaneous drug reaction and is potentially fatal, if not promptly managed. 1 It is reported with medications such as non-steroidal anti-inflammatory drugs, anticonvulsants, antibiotics (beta-lactam), allopurinol and barbiturates; immune checkpoint inhibitors can also result in Stevens-Johnson syndrome/toxic epidermal necrolysis uncommonly. Pembrolizumab is a highly selective humanised monoclonal IgG4 antibody, directed against the programmed cell death-1 protein receptor on the cell surface.…”