Kifayat Mammadli, A. Bilgic, H. İlhan, O. Dursun, M. Yılmaz, E. Alpsoy
{"title":"Stevens-Johnson综合征/中毒性表皮坏死松解症20例回顾性分析","authors":"Kifayat Mammadli, A. Bilgic, H. İlhan, O. Dursun, M. Yılmaz, E. Alpsoy","doi":"10.4103/tjd.tjd_13_22","DOIUrl":null,"url":null,"abstract":"Background: Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) are rare, acute, severe cutaneous hypersensitivity reactions usually triggered by medications. They are classified by the extent of the detached skin surface area. Objective: We aimed to retrospectively evaluate the sociodemographic, clinical, therapeutic, and prognostic characteristics of SJS/TEN cases diagnosed between January 2015 and December 2020 in our centre. Materials and Methods: All the data regarding patient characteristics were obtained retrospectively. The SCORe of Toxic Epidermal Necrolysis (SCORTEN) was used to predict disease severity and mortality rates. Results: Out of 20 patients (14 females, 6 males), eight (40%) were evaluated as TEN, three (15%) as SJS/ TEN overlap, and nine (45%) as SJS. The mean age was 39.2 ± 27.92 years. A higher frequency of systemic antibiotic use was found in cases of SJS/TEN overlap or TEN compared to SJS cases during patients’ follow-up after the diagnosis (P = 0.006). The most common responsible drug was allopurinol (25%). While the estimated mortality in patients with SCORTEN values of 4 and 5 was 58.3% and 90.0%, the mortality observed in our cohort was 50% and 100%, respectively. In terms of complications, ocular problems were the most common ones. Ophthalmic sequelae were observed in 15 patients during the follow-up period, the most common belonging to the cornea. Conclusion: In conclusion, early diagnosis, immediate discontinuation of suspected drugs, and good clinical care are among the most crucial treatment steps in the treatment of SJS/TEN. In addition, multidisciplinary management of the disease is vital in preventing the development of long-term sequelae in survivors.","PeriodicalId":42454,"journal":{"name":"Turk Dermatoloji Dergisi-Turkish Journal of Dermatology","volume":"35 1","pages":"80 - 86"},"PeriodicalIF":0.1000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retrospective analysis of cases with Stevens-Johnson syndrome/toxic epidermal necrolysis: A case series of 20 patients\",\"authors\":\"Kifayat Mammadli, A. Bilgic, H. İlhan, O. Dursun, M. Yılmaz, E. Alpsoy\",\"doi\":\"10.4103/tjd.tjd_13_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) are rare, acute, severe cutaneous hypersensitivity reactions usually triggered by medications. They are classified by the extent of the detached skin surface area. Objective: We aimed to retrospectively evaluate the sociodemographic, clinical, therapeutic, and prognostic characteristics of SJS/TEN cases diagnosed between January 2015 and December 2020 in our centre. Materials and Methods: All the data regarding patient characteristics were obtained retrospectively. The SCORe of Toxic Epidermal Necrolysis (SCORTEN) was used to predict disease severity and mortality rates. Results: Out of 20 patients (14 females, 6 males), eight (40%) were evaluated as TEN, three (15%) as SJS/ TEN overlap, and nine (45%) as SJS. The mean age was 39.2 ± 27.92 years. A higher frequency of systemic antibiotic use was found in cases of SJS/TEN overlap or TEN compared to SJS cases during patients’ follow-up after the diagnosis (P = 0.006). The most common responsible drug was allopurinol (25%). While the estimated mortality in patients with SCORTEN values of 4 and 5 was 58.3% and 90.0%, the mortality observed in our cohort was 50% and 100%, respectively. In terms of complications, ocular problems were the most common ones. Ophthalmic sequelae were observed in 15 patients during the follow-up period, the most common belonging to the cornea. Conclusion: In conclusion, early diagnosis, immediate discontinuation of suspected drugs, and good clinical care are among the most crucial treatment steps in the treatment of SJS/TEN. In addition, multidisciplinary management of the disease is vital in preventing the development of long-term sequelae in survivors.\",\"PeriodicalId\":42454,\"journal\":{\"name\":\"Turk Dermatoloji Dergisi-Turkish Journal of Dermatology\",\"volume\":\"35 1\",\"pages\":\"80 - 86\"},\"PeriodicalIF\":0.1000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Turk Dermatoloji Dergisi-Turkish Journal of Dermatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/tjd.tjd_13_22\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turk Dermatoloji Dergisi-Turkish Journal of Dermatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/tjd.tjd_13_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DERMATOLOGY","Score":null,"Total":0}
Retrospective analysis of cases with Stevens-Johnson syndrome/toxic epidermal necrolysis: A case series of 20 patients
Background: Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) are rare, acute, severe cutaneous hypersensitivity reactions usually triggered by medications. They are classified by the extent of the detached skin surface area. Objective: We aimed to retrospectively evaluate the sociodemographic, clinical, therapeutic, and prognostic characteristics of SJS/TEN cases diagnosed between January 2015 and December 2020 in our centre. Materials and Methods: All the data regarding patient characteristics were obtained retrospectively. The SCORe of Toxic Epidermal Necrolysis (SCORTEN) was used to predict disease severity and mortality rates. Results: Out of 20 patients (14 females, 6 males), eight (40%) were evaluated as TEN, three (15%) as SJS/ TEN overlap, and nine (45%) as SJS. The mean age was 39.2 ± 27.92 years. A higher frequency of systemic antibiotic use was found in cases of SJS/TEN overlap or TEN compared to SJS cases during patients’ follow-up after the diagnosis (P = 0.006). The most common responsible drug was allopurinol (25%). While the estimated mortality in patients with SCORTEN values of 4 and 5 was 58.3% and 90.0%, the mortality observed in our cohort was 50% and 100%, respectively. In terms of complications, ocular problems were the most common ones. Ophthalmic sequelae were observed in 15 patients during the follow-up period, the most common belonging to the cornea. Conclusion: In conclusion, early diagnosis, immediate discontinuation of suspected drugs, and good clinical care are among the most crucial treatment steps in the treatment of SJS/TEN. In addition, multidisciplinary management of the disease is vital in preventing the development of long-term sequelae in survivors.