Characteristics of toxic epidermal necrolysis and Stevens-Johnson syndrome: a 5-year retrospective study
Thammakumpee, J.; Yongsiri, S.
Journal of the Medical Association of Thailand 96(4): 399-406
2013
ISSN/ISBN: 0125-2208 PMID: 23691693 Document Number: 11393
Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SIS) are rare, unpredictable, life-threatening drug reaction with high mortality, and acute emergencies condition. There was no data about these patients in community base practice in Thailand. To study the demography, causative drugs, laboratory features, treatments, complications, and mortality of TEN/SJS in Chonburi Hospital and compare factors associated with mortality between groups. The medical records of TEN/SJS patients between 2005 and 2009 were retrospectively reviewed Characteristics of the patients and factors associated with mortality were analyzed by SPSS version 19for windows. There were 15 SJS and 9 TEN patients. The average age was 40.13 +/- 22 years. Male to female ratio was 1.4:1. The mean SCORTEN on day 1 was 1.54 +/- 1.1 and 1.79 +/- 1.59 on day 3. The overall mortality was 20.83%. Antibiotics were the commonest group of drugs causing TEN (55.6%) and SJS (66.7%). Septicemia and pulmonary infections were associated with higher mortality (p<0.001 and 0.004 respectively). Steroid treatment was associated with lower mortality 13.33% vs. 33.33%. Antibiotics are the most common causative agents in SIS/TEN. Sepsis andpulmonary infections are associated with higher mortality. Steroid treatment may have some survival benefit.
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