Stevens-Johnson syndrome and toxic epidermal necrolysis in a referral center in Taiwan
| Autor: | Kwei-Lan Liu, Ting-Jung Hsu, Chih-Hung Lee, Hsu-Hang Yeh |
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| Rok vydání: | 2021 |
| Předmět: |
Drug
medicine.medical_specialty medicine.drug_class media_common.quotation_subject Antibiotics Taiwan Dermatology Culprit 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Internal medicine Severity of illness Medicine Humans Referral and Consultation media_common Retrospective Studies business.industry Mortality rate Carbamazepine Middle Aged medicine.disease Toxic epidermal necrolysis Immune checkpoint 030220 oncology & carcinogenesis Stevens-Johnson Syndrome Anticonvulsants business medicine.drug |
| Zdroj: | International journal of dermatologyReferences. 60(8) |
| ISSN: | 1365-4632 |
| Popis: | Background Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal adverse drug reactions. The characteristics of these diseases are changing with the use of novel drugs, posing new challenges to doctors. We aimed to review recent SJS/TEN cases in order to assist general practitioners with timely diagnosis and correct management. Methods We conducted a retrospective chart review of SJS/TEN patients in a referral center in Taiwan from 2009 to 2019. We included 24 patients' charts and analyzed demographic data, medication histories, clinical courses, human leukocyte antigen (HLA) alleles, and long-term complications. Results The average age was 63.4 years, and the average toxic epidermal necrolysis-specific severity of illness score was 1.9. The most common culprit drug was carbamazepine (33.3%), followed by antibiotics (12.5%) and nonsteroidal anti-inflammatory drugs (8.3%). Two cases were caused by immune checkpoint inhibitors, and one of them had a long latency of 210 days. Three out of the four patients carrying HLA-B*15:02 had carbamazepine-induced SJS/TEN. All patients were treated with systemic corticosteroids in the acute stage of the diseases. The length of in-hospital stay did not correlate with the average daily dose of corticosteroids. The overall mortality rate was 4.2%, and the disease-specific mortality rate was 0%. Conclusions The most common culprit drug was carbamazepine, which had strong association with HLA-B*15:02. There was no statistically significant correlation between in-hospital stay and the average daily dose of corticosteroids. Immune checkpoint inhibitor-related SJS/TEN may have an extended latent period. |
| Databáze: | OpenAIRE |
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