A Clinical Study of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis over the Last Five-year Period in the Gwangju-Chonnam Area / 대한피부과학회지

ABSTRACT

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions which are most frequently caused by drugs. The incidence of SJS and TEN is known to be relatively low, however the outcomes may be fatal. OBJECTIVES: To investigate the clinical feature and outcome of 32 patients diagnosed with SJS and TEN. METHODS: Thirty two patients (17 males, 15 females, mean age 50.8 years) with SJS and TEN, diagnosed at the Department of Dermatology, Chonnam National University Hospital from January 2001 to December 2005, were retrospectively evaluated. RESULTS: Thirty two patients were clinically classified with SJS (n=15, 46.9%), overlap SJS/TEN (n=3, 9.4%) and TEN (n=14, 43.7%). Non-steroidal anti-inflammatory drugs (NSAIDs) were most commonly suspected as the causative drug in this series. All patients had involvement of the mucosa, except two. More than two sites were affected in 68.8 percent of cases. Nineteen patients (59.4%) showed abnormal liver function and three patients (9.4%) showed abnormal renal function. Five patients (15.6%) showed leukocytopenia and twenty four patients showed increased lactate dehydrogenase activity. Complications, mainly in the TEN group, included pneumonia, toxic hepatitis, wound infection, septicemia and multiorgan failure. Two patients died from septicemia and multiorgan failure. CONCLUSION: The mortality from SJS and TEN has been quoted as being about 5% and 30%, respectively. However, the mortality in our study was relatively low (SJS 0%, TEN 14.3%). Early intensive treatment is important for reducing the mortality rate in SJS/TEN.