A 12-year retrospective study of non-burn skin loss (burn-like syndromes) at a tertiary burns unit in a developing country

Burns. 2008 Aug;34(5):637-43. doi: 10.1016/j.burns.2007.08.022. Epub 2008 Jan 15.

Abstract

Background: A retrospective study of the presentation, etiology, and prognosis of non-burn epidermal loss managed at the Lagos University Teaching Hospital Nigeria over a 12-year period.

Materials and methods: Admission records of patients managed for non-burn skin loss were retrieved from the medical records. Demographic details of the patients, the initial diagnosis, final diagnosis, treatment and outcome of treatment was noted.

Results: A total of 23 patients were identified, 17 (74%) had idiosyncratic drug reactions. Of this 17, 6 (26%) had Steven Johnson Syndrome, 6 (26%) had Steven Johnson Syndrome/toxic epidermal necrolysis while 5 (22%) presented with toxic epidermal necrolysis. Three of the five patients with toxic epidermal necrolysis died. The age range of patients with idiosyncratic adverse drug reactions was 2-28 years, mean, 10.18+/-1.44 years and male to female ratio of 1:1.83. The body surface area involved ranged from 8 to 78%; mean 26.65+/-6.08%. The agents suspected for the reactions were Co-trimoxazole (41.2%) and combination of Co-trimoxazole, and Fansidar (17.6%). Other conditions seen were two (9%) Staphylococcal Scalded Skin Syndrome, three (13%) had Necrotizing Faciitis, one of whom was HIV positive and died. One (4%) patient presented with pemphigus vulgaris. The presentation and management of the patients was discussed.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Infective Agents / adverse effects
  • Bandages / adverse effects
  • Burn Units
  • Child
  • Child, Preschool
  • Developing Countries*
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Nigeria
  • Prognosis
  • Pyrimethamine / adverse effects
  • Retrospective Studies
  • Staphylococcal Scalded Skin Syndrome / etiology
  • Staphylococcal Scalded Skin Syndrome / pathology
  • Stevens-Johnson Syndrome / etiology*
  • Stevens-Johnson Syndrome / pathology
  • Stevens-Johnson Syndrome / therapy
  • Sulfadoxine / adverse effects
  • Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects

Substances

  • Anti-Infective Agents
  • Drug Combinations
  • fanasil, pyrimethamine drug combination
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Sulfadoxine
  • Pyrimethamine