Characteristics of Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome: A 5-Year Retrospective Study

Jiranuch Thammakumpee MD*, Somchai Yongsiri MD**

Affiliation : * Internal Medicine Department, Chonburi Hospital, Chonburi, Thailand ** Faculty of Medicine, Burapha University, Chonburi, Thailand

Background : Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare, unpredictable, life-threatening drug reaction with high mortality, and acute emergencies condition. There was no data about these patients in community base practice in Thailand.
Objective : To study the demography, causative drugs, laboratory features, treatments, complications, and mortality of TEN/SJS in Chonburi Hospital and compare factors associated with mortality between groups. Material and Method: The medical records of TEN/SJS patients between 2005 and 2009 were retrospectively reviewed. Characteristics of the patients and factors associated with mortality were analyzed by SPSS version 19 for windows.
Results : There were 15 SJS and 9 TEN patients. The average age was 40.1322 years. Male to female ratio was 1.4:1. The mean SCORTEN on day 1 was 1.541.1 and 1.791.59 on day 3. The overall mortality was 20.83%. Antibiotics were the commonest group of drugs causing TEN (55.6%) and SJS (66.7%). Septicemia and pulmonary infections were associated with higher mortality (p<0.001 and 0.004 respectively). Steroid treatment was associated with lower mortality 13.33% vs. 33.33%.
Conclusion : Antibiotics are the most common causative agents in SJS/TEN. Sepsis and pulmonary infections are associated with higher mortality. Steroid treatment may have some survival benefit.

Keywords : Stevens-Johnson syndrome, Toxic epidermal necrolysis

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