Characteristics of toxic epidermal necrolysis and Stevens-Johnson syndrome: a 5-year retrospective study.

BACKGROUND: Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SIS) are rare, unpredictable, life-threatening drug reaction with high mortality, and acute emergencies condition. There was no data about these patients in community base practice in Thailand.

OBJECTIVE: To study the demography, causative drugs, laboratory features, treatments, complications, and mortality of TEN/SJS in Chonburi Hospital and compare factors associated with mortality between groups.

MATERIAL AND METHOD: The medical records of TEN/SJS patients between 2005 and 2009 were retrospectively reviewed Characteristics of the patients and factors associated with mortality were analyzed by SPSS version 19for windows.

RESULTS: There were 15 SJS and 9 TEN patients. The average age was 40.13 +/- 22 years. Male to female ratio was 1.4:1. The mean SCORTEN on day 1 was 1.54 +/- 1.1 and 1.79 +/- 1.59 on day 3. The overall mortality was 20.83%. Antibiotics were the commonest group of drugs causing TEN (55.6%) and SJS (66.7%). Septicemia and pulmonary infections were associated with higher mortality (p<0.001 and 0.004 respectively). Steroid treatment was associated with lower mortality 13.33% vs. 33.33%.

CONCLUSION: Antibiotics are the most common causative agents in SIS/TEN. Sepsis andpulmonary infections are associated with higher mortality. Steroid treatment may have some survival benefit.