Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome

Abstract

Little work has been carried out on the epidemiology of the two serious skin reactions--toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). We collected details of all the hospitalized cases of TEN and SJS in the Federal Republic of Germany for the years 1981 through 1985 inclusive. Inquiries by telephone, letter, and personal visits produced an overall response of 91%; 259 cases of TEN and 315 cases of SJS were identified. From these data, we were able to calculate an overall annual risk of 0.93 and 1.1 per million for TEN and SJS, respectively. The average age group was higher for TEN (63 years) than for SJS (25 years). Women are markedly more at risk for TEN in the ratio of 2:1, these figures being reversed for SJS. The mortality was 34% (87/259) for TEN and only 1% (2/315) for SJS. An association with previous medication defined as "definite, probable, possible" could be established for 89% of cases of TEN and 54% of cases of SJS. The drugs most commonly involved were antibiotics (TEN, 40%; SJS, 34%), followed by the analgesics (TEN, 23%; SJS, 33%). As with the drug groups, the incidences being based on the defined daily doses, were high for sulfonamides, beta-lactam antibiotics, and some nonsteroidal anti-inflammatory drugs.

Severe Drug Eruption in Guinea Conakry

“…In most of these studies with the exception of Togolese one, these drug reactions were attributable to thiacetazone. In addition, unlike the European and Asian studies [12] [13] [17] [18], drugs against gout, such as allopurinol, were not found in African studies except ours where this molecule was found in 3 cases, probably due to its low use by people in Africa [19]. Furthermore, no infectious cause was found in our patients because of the non-realization of mycoplasma serology, PCR and blood culture.…”

A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population

“…[1,2] It is 1.1 and 0.93 per million per year for SJS and TEN respectively in Germany. [3] Drugs are most commonly implicated for causing 77-95% of cases. [4,5] SJS/TEN have been observed with more than 100 drugs.…”

Cyclosporine in Stevens Johnson syndrome and toxic epidermal necrolysis and retrospective comparison with systemic corticosteroid

“…[2,3] The mortality rate of SJS and TEN is high; approximately, 5% for SJS [4] and 30% for TEN. [5] Now SJS, SJS-TEN overlap and TEN are considered a spectrum of the same condition having common risk factors and causes, differentiated only by the extent of the body surface area (BSA) involved. Patients with epidermal detachment involving less than 10% of BSA are classified as having SJS, more than 30% BSA as TEN and 10-30% as SJS/TEN overlap.…”