[Stevens-Johnson syndrome and toxic epidermal necrolysis]

Actas Dermosifiliogr. 2006 Apr;97(3):177-85. doi: 10.1016/s0001-7310(06)73376-2.
[Article in Spanish]

Abstract

Introduction: The aim of this work is to reflect the clinical experience of the Dermatology Department of Hospital General in Valencia with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) or Lyell's syndrome over the last 15 years.

Methods: Data on epidemiology, likely causal agents, complementary tests, concomitant pathologies, management, evolution and complications was gathered through a retrospective study.

Results: Thirteen patients were included, with a mean age of 53 years. The most frequently involved drugs were antibiotics (50 %), followed by anti-convulsants (16.6 %). The mucous membranes were involved in 84.6 % of the cases. 61.5 % of the patients presented with systemic symptoms. The most frequent laboratory finding was hypoproteinemia. Corticosteroids were used in 69 % of the cases, and intravenous immunoglobulins in 15 %. Two oncological patients with a diagnosis of TEN died (15 % overall mortality).

Conclusions: SJS and TEN are infrequent mucocutaneous reactions, often drug induced, with significant associated morbidity and mortality. Their pathogenesis is still partially unknown, and no specific treatment has been proven to be clearly beneficial; therefore, the best treatment consists of early diagnosis, the withdrawal of the suspect drug and support therapy.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Erythema Multiforme / diagnosis
  • Female
  • Humans
  • Immunotherapy
  • Male
  • Retrospective Studies
  • Spain / epidemiology
  • Stevens-Johnson Syndrome / chemically induced
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / drug therapy
  • Stevens-Johnson Syndrome / epidemiology*
  • Stevens-Johnson Syndrome / etiology
  • Stevens-Johnson Syndrome / therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents