Korean J Dermatol.  2021 Sep;59(8):604-610.

Clinical Features and Prognostic Factors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Multicenter Retrospective Study of Data from 88 Patients

• Hong JY
• Chung EH
• Yang NG
• Kim JY
• Heo NH
• Lee SH
• Kim JE
• Lee SY

Abstract

Background
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary.
Objective
To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data.
Methods
The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed.
Results
We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN.
Conclusion
Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population.

Keyword

Drug hypersensitivity; Stevens-Johnson syndrome