Epidermal necrolysis: SCORTEN performance in AIDS and non-AIDS patients
An. bras. dermatol
;
94(1): 17-23, Jan.-Feb. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-983746
ABSTRACT
Abstract Background:
Stevens-Johnson syndrome and toxic epidermal necrolysis are life-threatening blistering drug reactions with high incidence of ocular sequela. The term 'Epidermal Necrolysis' has been recently used to better describe the full spectrum of the disease that includes Stevens-Johnson syndrome and toxic epidermal necrolysis at opposite ends, which differ by the extent of body surface area with epidermal detachment. SCORTEN is a mortality prognosis score for 'Epidermal Necrolysis' cases that still needed validation in acquired immunodeficiency syndrome.Objective:
To evaluate the SCORTEN performance in acquired immunodeficiency syndrome, and the differences in outcomes between acquired immunodeficiency syndrome and non- acquired immunodeficiency syndrome cohorts.Methods:
Retrospective cohort study of AIDS and non-AIDS 'Epidermal Necrolysis' cases admitted to a Brazilian reference center from 1990-2014.Results:
Five deaths (16.7%) occurred as a consequence of EN in 30 AIDS patients, and seven (17.9%) in 39 non-AIDS patients, relative risk (RR) .92 (p=1.0). SCORTEN showed great performance, with an Area Under the Receiver Operating Curve (AUC) (ROC) of 0.90 with a 95% confidence interval ranging from .81 to .99. The performance of SCORTEN was better among non- AIDS patients than AIDS patients AUC non- acquired immunodeficiency syndrome =0.99 (CI 05% 0.96-1.00), AUC acquired immunodeficiency syndrome = 0.74 (CI 95% 0.53-0.95), p=.02. StudyLimitations:
Heterogeneity of cases, wide variation of systemic corticosteroid doses when used.Conclusion:
SCORTEN is valid for the Brazilian population, including among those patients with acquired immunodeficiency syndrome, and, as such, its use is recommended for aiding treatment choice in this subgroup of patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Severity of Illness Index
/
Acquired Immunodeficiency Syndrome
/
Stevens-Johnson Syndrome
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
An. bras. dermatol
Journal subject:
Dermatology
Year:
2019
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Estadual de Ponta Grossa/BR
/
Universidade de São Paulo/BR
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