A retrospective analysis of Stevens-Johnson syndrome/toxic epidermal necrolysis treated with corticosteroids
| Autor: | Wen-min Liu, Xiao-juan Nie, Li Zhang |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Mucocutaneous zone Dermatology Severity of Illness Index 030207 dermatology & venereal diseases 03 medical and health sciences Young Adult 0302 clinical medicine Pharmacotherapy Adrenal Cortex Hormones Internal medicine Severity of illness medicine Humans Child Survival rate Serum Albumin Retrospective Studies business.industry Mortality rate Retrospective cohort study Length of Stay Middle Aged medicine.disease Toxic epidermal necrolysis Anti-Bacterial Agents Survival Rate Standardized mortality ratio 030228 respiratory system Child Preschool Stevens-Johnson Syndrome Drug Therapy Combination Female business |
| Zdroj: | International journal of dermatology. 55(12) |
| ISSN: | 1365-4632 |
| Popis: | Background Toxic epidermal necrolysis (TEN) and Stevens–Johnson syndrome (SJS) are severe mucocutaneous reactions that incur high mortality, and in which the systemic application of corticosteroids remains controversial. Objective This study aimed to determine the optimal protocols for the use of corticosteroids and treatment measures. Methods We performed a retrospective analysis of 70 patients with SJS/TEN who were hospitalized between January 2008 and May 2015 in the Department of Dermatology, Shandong Provincial Hospital, and treated with corticosteroids. Expected and actual mortality rates in patients treated with different doses of corticosteroids, according to SCORTEN, were compared. Results The diagnoses associated with initial corticosteroid use differed significantly between the low- and high-dose groups (P = 0.041). There were significant differences between expected and actual mortality rates according to the use of corticosteroid therapy (P = 0.0168, standardized mortality ratio [SMR] = 0.30). There was a statistical difference between expected and actual mortality rates in the low-dose group (P = 0.0145, SMR = 0.20). Serum albumin levels were significantly lower in patients administered corticosteroids additive therapy (31.12 ± 8.32 g/l vs. 35.54 ± 5.82 g/l; P = 0.016), and the rate of use of antibiotics was higher among patients in the additive therapy group than in the non-additive group (94.7% vs. 60.8%). Conclusions Our research supports the use of corticosteroids for the systemic treatment of SJS/TEN. Corticosteroids should be used in a timely manner and in accordance with disease severity, age, underlying diseases, serum albumin level, and concurrent treatment with antimicrobial therapy. |
| Databáze: | OpenAIRE |
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