Drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children: 20 years study in a tertiary care hospital

Background: Cutaneous drug reaction (CDR) is a growing health hazard in the world. Adverse drug reactions are common complications in drug therapy. About 3-8% of all hospital admissions are the results of adverse drug reactions, among them 2-3% are children and these can cause significant disability to patients. Early identification and management of adverse cutaneous drug reaction has both short term and long term prognostic significance. Objective: To know the cutaneous reaction to drugs in children in a tertiary care hospital. Study design: Hospital based descriptive, observational study. Subjects: 50 children with cutaneous drug reactions were studied in the department of Dermatology and Pediatric respectively in Rajshahi Medical College Hospital, Rajshahi. Methods: Data were collected by detailed history taking, physical examination and laboratory investigations in a prefixed data collection sheet and with the help of GOLD guideline after taken informed consent of the patient. Results: This study showed a significant male predominance. Male: female ratio was 1.08:1 .In this study prevalence was highest among 1-5 years age group. Cotrimoxazole, NSAIDs, anticonvulsant and quinolone were most offending medications. Maculopapular eruption, Stevens Johnson Syndrome, fixed drug eruption and urticaria were most common morphological types. Majority of CDRs were noted with oral route of administration. It was observed that almost all the CDRs that were reported involved mainly the skin. Majority of adverse cutaneous drug reactions reported were moderate in severity. Conclusion: Frequency distribution of the offending drugs and the adverse reactions revealed that adverse cutaneous drug reactions occurred mostly by cotrimoxazole, NSAIDs and quinolones. Maculopapular rash and Stevens Johnson Syndrome were the most common morphological types. A better understanding of the mechanisms underlying CRDs is important in drug development and in patient care. TAJ 2020; 33(2): 56-62

Download Full-text

Carbamazepine induced Stevens Johnson Syndrome: a case report from a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183039 ◽

2018 ◽

Vol 7 (8) ◽

pp. 1654

Author(s):

Jyoti B. Gadhade ◽

Rajesh S. Hiray ◽

Balasaheb B. Ghongane

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

The Body ◽

Stevens Johnson Syndrome ◽

Care Hospital ◽

Common Cause ◽

Johnson Syndrome ◽

Intravenous Antibiotics ◽

Life Threatening ◽

Ulcerative Lesions

Stevens Johnson Syndrome is a rare but life-threatening skin disease and Carbamazepine is considered as one of the most common cause. The reported frequency of serious Carbamazepine hypersensitivity reaction is between 1/1000 and 1/10000 new exposures to the drug. Here, we report a case of a 40 year old female patient, who developed multiple ulcerative lesions all over the body three days after starting treatment with Carbamazepine for Trigeminal Neuralgia. (Worldwide Unique Number- 2017-58502 and AMC Report Number- BJGMC-Pune/Nov-2017/BBG-1860) Stevens Johnson Syndrome was diagnosed. Carbamazepine was withdrawn, and the patient was treated with topical and intravenous antibiotics. A biopsy was done which confirmed the diagnosis of Stevens Johnson Syndrome.

Download Full-text

Retrospective review of drug‐induced Stevens‐Johnson syndrome and toxic epidermal necrolysis cases at a pediatric tertiary care institution

Pediatric Dermatology ◽

10.1111/pde.14118 ◽

2020 ◽

Vol 37 (3) ◽

pp. 461-466 ◽

Cited By ~ 2

Author(s):

Cathryn Sibbald ◽

Elana Putterman ◽

Robert Micheletti ◽

James Treat ◽

Leslie Castelo‐Soccio

Keyword(s):

Toxic Epidermal Necrolysis ◽

Retrospective Review ◽

Tertiary Care ◽

Stevens Johnson Syndrome ◽

Drug Induced ◽

Care Institution ◽

Johnson Syndrome ◽

Tertiary Care Institution

Download Full-text

Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis; Extensive Review of Reports of Drug-Induced Etiologies, and Possible Therapeutic Modalities

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.148 ◽

2018 ◽

Vol 6 (4) ◽

pp. 730-738 ◽

Cited By ~ 8

Author(s):

Adegbenro Omotuyi John Fakoya ◽

Princess Omenyi ◽

Precious Anthony ◽

Favour Anthony ◽

Precious Etti ◽

...

Keyword(s):

Adverse Drug Reaction ◽

Toxic Epidermal Necrolysis ◽

Stevens Johnson Syndrome ◽

Hypersensitivity Reactions ◽

Extensive Review ◽

Drug Induced ◽

Therapeutic Modalities ◽

Johnson Syndrome ◽

Mucous Membranes ◽

Degrees Of Severity

Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis are adverse hypersensitivity reactions that affect the skin and mucous membranes. They are characterised by erythematous macules and hemorrhagic erosions of the mucous membranes. Epidermal detachments of varying degrees of severity also occur in these conditions. Various aetiologies are associated with these conditions, with adverse drug reaction being the most common. Though the worldwide incidence of these conditions is recorded as low, diverse types of medication are being observed to lead to these conditions. This review compiles information on the details of Stevens-Johnson syndrome and Toxic Epidermal Necrolysis, the pathophysiology, therapeutic management, and largely considers the drug-induced etiologies associated with these conditions.

Download Full-text

Causative drugs and HLA-B polymorphism in drug-induced Stevens-Johnson syndrome - toxic epidermal necrolysis: A study in five hospitals in Jakarta

Dermatology Reports ◽

10.4081/dr.2019.8052 ◽

2019 ◽

Author(s):

Anesia Tania ◽

Evita Halim Effendi ◽

Inge Ade Krisanti ◽

Yulia Ariani

Keyword(s):

Toxic Epidermal Necrolysis ◽

Drug Eruption ◽

Stevens Johnson Syndrome ◽

Allele Polymorphism ◽

Exclusion Criteria ◽

Drug Induced ◽

Causative Drug ◽

Johnson Syndrome ◽

Luminex Technology ◽

Referral Hospitals

Stevens-Johnson syndrome and toxic epidermal necrolysis is a very rare but lifethreatening form of cutaneous drug eruption. In recent years, several countries in Asia had succeded in preventing carbamazepine induced SJS/TEN by screening for HLA-B*15:02 before prescribing carbamazepine. This study aimed to acquire data regarding causative drugs and HLA-B allele polymorphism in SJS/TEN patient in Jakarta. We acquired data from 5 referral hospitals from March 2015 to March 2017. Subject fulfilling the inclusion and exclusion criteria was interviewed and blood sample was taken for DNA extraction. The DNA was examined with PCR SSOP and Luminex technology for high resolution HLA-B typing. We studied 22 subjects. The median age was 45,4 years old (14-74). The most common causative drug in this study is carbamazepine. HLA-B*15:02 and HLAB* 18:01 were the most common allele in all subjects. HLA-B*15:02 was found in five (72%) out of seven subjects whose condition was caused by carbamazepine. The most common causative drug of SJS/TEN in five hospitals in Jakarta is carbamazepine, with five (72%) out seven subjects had HLA-B*15:02 allele.

Download Full-text