Stevens-Johnson syndrome and toxic epidermal necrolysis: a report of six cases

Stevens-Johnson syndrome and toxic epidermal necrolysis are severe cutaneousadverse reactions commonly caused by exposure to drugs and can end upwith significant morbidity and mortality. We reported our experience withsix patients who were diagnosed with Stevens-Johnson Syndrome or ToxicEpidermal Necrolysis with a different clinical presentation. In patients, drugsand Mycoplasma pneumoniae infection were implicated as a trigger. IntravenousImmunoglobulin treatment was given to all patients, and intensive treatmentwas applied for skin and mucosal lesions. The median period of stay inhospital was 13.5 days. The most common long-term complication was ocularinvolvement. Among six patients, corneal epithelial defects occurred in onepatient. Consequently, ophthalmological evaluation should be performed bothat the time of diagnosis and before hospital discharge.

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1. Martínez-Cabriales SA, Gómez-Flores M, OcampoCandiani J. Actualidades en farmacodermias severas: síndrome de Stevens-Johnson (SSJ) y necrólisis epidérmica tóxica (NET). Gac Med Mex 2015; 151: 777-787.

2. Ferrandiz-Pulido C, Garcia-Patos V. A review of causes of Stevens-Johnson syndrome and toxic epidermal necrolysis in children. Arch Dis Child 2013; 98: 998- 1003.

3. Mockenhaupt M. The current understanding of Stevens-Johnson syndrome and toxic epidermal necrolysis. Expert Rev Clin Immunol 2011; 7: 803- 813.

4. Roujeau J, Bastuji-Garin S. Systematic review of treatments for Stevens- Johnson syndrome and toxic epidermal necrolysis using the SCORTEN score as a tool for evaluating mortality. Ther Adv Drug Saf 2011; 2: 87-94.

5. Spies M, Sanford AP, Aili Low JF, Wolf SE, Herndon DN. Treatment of extensive toxic epidermal necrolysis in children. Pediatrics 2001; 108: 1162-1168.

6. French LE. Toxic epidermal necrolysis and Stevens Johnson syndrome: our current understanding. Allergol Int 2006; 55: 9-16.

7. Revuz J, Penso D, Roujeau JC, et al. Toxic epidermal necrolysis. Clinical findings and prognosis factors in 87 patients. Arch Dermatol 1987; 123: 1160-1165.

8. Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol 1993; 129: 92-96.

9. Kunimi Y, Hirata Y, Aihara M, Yamane Y, Ikezawa Z. Statistical analysis of Stevens-Johnson syndrome caused by Mycoplasma pneumonia infection in Japan. Allergol Int 2011; 60: 525-532.

10. Wetter DA, Camilleri MJ. Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic. Mayo Clinic Proc 2010; 85: 131-138.

11. Mockenhaupt M, Messenheimer J, Tennis P, Schlingmann J. Risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptics. Neurology 2005; 64: 1134-1138.

12. Çekiç Ş, Canıtez Y, Sapan N. Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience. Turk Pediatri Ars 2016; 51: 152-158.

13. Mawson AR, Eriator I, Karre S. Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN): could retinoids play a causative role? Med Sci Monit 2015; 21: 133-143.

14. Dodiuk-Gad RP, Chung WH, Valeyrie-Allanore L, Shear NH. Stevens-Johnson syndrome and toxic epidermal necrolysis: An update. Am J Clin Dermatol 2015; 16: 475-493.

15. Barron SJ, Del Vecchio MT, Aronoff SC. Intravenous immunoglobulin in the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis: a metaanalysis with meta-regression of observational studies. Int J Dermatol 2015; 54: 108-115.

16. Huang YC, Li YC, Chen TJ. The efficacy of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis: a systematic review and metaanalysis. Br J Dermatol 2012; 167: 424-432.

17. Prins C, Kerdel FA, Padilla RS, et al. Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol 2003; 139: 26-32.

18. Del Pozzo-Magana BR, Lazo-Langner A, Carleton B, Castro-Pastrana LI, Rieder MJ. A systematic review of treatment of drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children. J Popul Ther Clin Pharmacol 2011; 18: e121-e133.

19. Chang YS, Huang FC, Tseng SH, Hsu CK, Ho CL, Sheu HM. Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis: acute ocular manifestations, causes, and management. Cornea 2007; 26: 123-129.

20. Sotozono C, Ueta M, Koizumi N, et al. Diagnosis and treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis with ocular complications. Ophthalmology 2009; 116: 685-690.

21. Yeung CK, Lam LK, Chan HH. The timing of intravenous immunoglobulin therapy in StevensJohnson syndrome and toxic epidermal necrolysis. Clin Exp Dermatol 2005; 30: 600-602.

22. Fracaroli TS, Miranda LQ, Sodré JL, Chaves M, Gripp A. Toxic epidermal necrolysis induced by lansoprazole. An Bras Dermatol 2013; 88: 117-120.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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