Clinical Features and Treatment Outcomes among Children with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 20-Year Study in a Tertiary Referral Hospital

Aim. To determine the probable causative factors, clinical features, and treatment outcomes of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS-TEN overlap in children.Methods. A 20-year database review of all children diagnosed with SJS/TEN/SJS-TEN overlap at the King Chulalongkorn Memorial Hospital, Thailand.Results. 36 patients (M : F, 16 : 20) with the mean age of9.2±4.0years were identified. There were 20 cases of SJS, 4 cases of SJS-TEN overlap, and 12 cases of TEN. Drugs were the leading cause for the diseases (72.3%); antiepileptics were the most common culprits (36.1%). Cutaneous morphology at presentation was morbilliform rash (83.3%), blister (38.9%), targetoid lesions (25.0%), and purpuric macules (2.8%). Oral mucosa (97.2%) and eye (83.3%) were the 2 most common mucosal involvements. Majority of the cases (77.8%) were treated with systemic corticosteroids, intravenous immunoglobulin, or both. Treatment outcomes between those who received systemic therapy and those who received only supportive care were comparable. Skin and eye were the principal sites of short-term and long-term complications.Conclusions. SJS/TEN are not common but are serious diseases which lead to significant morbidities in children. Early withdrawal of suspicious causes and meticulous supportive care are very important. This study found that the systemic therapy was not superior to supportive care because the treatment outcomes for both groups were comparable.

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Faculty Opinions recommendation of Clinical Features and Treatment Outcomes among Children with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 20-Year Study in a Tertiary Referral Hospital.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733381972.793576489 ◽

2020 ◽

Author(s):

Michele Ramien

Keyword(s):

Toxic Epidermal Necrolysis ◽

Treatment Outcomes ◽

Clinical Features ◽

Referral Hospital ◽

Stevens Johnson Syndrome ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Johnson Syndrome

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A Four Years Retrospective Study of Stevens Johnson Syndrome: Toxic Epidermal Necrolysis Treatments in a National Tertiary Referral Hospital

Proceedings of the 23rd Regional Conference of Dermatology ◽

10.5220/0008151300830087 ◽

2018 ◽

Author(s):

Sarah Mahri ◽

Teffy Nuary ◽

Fadhli A. Mughni ◽

Windy Keumala B.

Keyword(s):

Retrospective Study ◽

Toxic Epidermal Necrolysis ◽

Referral Hospital ◽

Stevens Johnson Syndrome ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Johnson Syndrome

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Multidisciplinary care in Stevens-Johnson syndrome

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622319894469 ◽

2020 ◽

Vol 11 ◽

pp. 204062231989446 ◽

Cited By ~ 1

Author(s):

Swapna S. Shanbhag ◽

James Chodosh ◽

Cherie Fathy ◽

Jeremy Goverman ◽

Caroline Mitchell ◽

...

Keyword(s):

Supportive Care ◽

Toxic Epidermal Necrolysis ◽

Oral Mucosa ◽

Acute Phase ◽

Multidisciplinary Care ◽

Stevens Johnson Syndrome ◽

Chronic Complications ◽

Optimal Care ◽

Johnson Syndrome ◽

Organ Systems

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are potentially fatal mucocutaneous diseases that can involve many organ systems. Manifestations of SJS/TEN outside of the skin, eyes, and oral mucosa are not well defined or well recognized, and, therefore, are often not addressed clinically. As supportive care improves and mortality from SJS/TEN decreases, chronic complications in affected organ systems are becoming more prevalent. Recognition of the manifestations of SJS/TEN in the acute phase is critical to optimal care. In this review, we review the organ systems that may be involved in SJS/TEN, provide an overview of their management, and propose a list of items that should be communicated to the patient and family upon discharge. The organ systems discussed include the pulmonary, gastrointestinal/hepatic, oral, otorhinolaryngologic, gynecologic, genitourinary, and renal systems. In addition, the significant psychosocial, nutritional, and pain consequences and management of SJS/TEN are discussed.

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