ABSTRACT
Stevens-Johnson Syndrome (SJS) may have considerable morbidity and mortality. Traditional management has been supportive with or without corticosteroids, and we have previously reported our successful experience treating 41 SJS patients with corticosteroids. We now report the outcome of prospectively treating 13 additional patients with SJS with high doses of corticosteroids. Thirteen consecutive patients with SJS were treated with corticosteroids at diagnosis. Their clinical course and outcomes were analyzed. Drug reactions were potential precipitants of SJS in 12 patients. The percent of skin involvement ranged from 30% to 90% with eight patients having greater than 80% involvement. Bullous lesions were seen in two patients. All patients made a complete recovery. Corticosteroid therapy may be lifesaving in these patients; and in our experience, early management of SJS with high dose corticosteroids has been very effective and associated with a full recovery.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Stevens-Johnson Syndrome/drug therapy , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Adult , Aged , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Prospective Studies , Stevens-Johnson Syndrome/chemically induced , Stevens-Johnson Syndrome/pathology , Treatment OutcomeABSTRACT
Evaluation of therapy for Stevens-Johnson syndrome was initiated as a retrospective analysis and then extended to a prospective series of patients treated with corticosteroids. This report extends the initial prospective study of patients with Stevens-Johnson syndrome treated with corticosteroids and evaluates the total series of 41 patients relative to outcome and the presumptive etiology. We propose that management of Stevens-Johnson syndrome requires corticosteroid therapy and that the survival of patients with Stevens-Johnson syndrome may depend on this therapy. No fatalities or adverse effects due to corticosteroids were noted. Stevens-Johnson syndrome due to a drug, a drug metabolite or viral infection may mimic a graft-versus-host reaction in which the patient rejects skin, mucous membrane, kidney or liver cells to which the drug, drug metabolite, or virus has bound. Corticosteroids suppress the inflammatory rejection until the activating agent has been eliminated.
