Stevens-Johnson syndrome and Toxic epidermal necrolysis: clinical manifestations, etiologies and complications in HRH Princess Maha Chakri Sirindhorn Medical Center

Piyakan Limtanyakul; Rithee Smithrithee

Authors

Piyakan Limtanyakul DIVISION OF DERMATOLOGY, DEPARTMENT OF MEDICINE, FACULTY OF MEDICINE, SRINAKARINWIROT UNIVERSITY, ONGKHARAK, NAKHON NAYOK, THAILAND
Rithee Smithrithee DIVISION OF DERMATOLOGY, DEPARTMENT OF MEDICINE, FACULTY OF MEDICINE, SRINAKARINWIROT UNIVERSITY, ONGKHARAK, NAKHON NAYOK, THAILAND.

Keywords:

Stevens-Johnson syndrome, Toxic epidermal necrolysis, etiology, complication

Abstract

Objectives: To determine clinical manifestations, etiologies, and complications of Stevens-Johnson syndrome (SJS) /Toxic epidermal necrolysis (TEN)

Method: Retrospetive chart review of 8 patients with SJS/TEN admitted in HRH Maha Chakri Sirindhorn Medical Center during the past 4 years (January 2009 to December 2012).

Results: The average age was 50.37± 28.27 year olds. Female was more affected than male (3:1). Mean duration of onset was 25 days (3-240 days). The

mortality rate of SJS and TEN were 25% and 75%, respectively.The common drugs that implicated were antibiotics (n=2), anticonvulsants (n=2), and allopurinol (n=2). Tramadol was first report to be the cause of SJS. The most common underlying disease was metabolic syndrome (n=3). The common complications were sepsis (n=5) and urinary tract infection (n=5).

Conclusion: SJS/TEN is low incidence but high mortality rate adverse drug reaction. The diseases affect more woman than man. Among drugs that cause SJS/TEN, antibiotics, anticonvulsants, and allopurinol were common. Moreover, Tramadol was first reported to be the cause of SJS. In our study, old patients with underlying diseases, multi-drugs administration, and long-term use of the drugs were related to more serious complication and higher mortality rate.

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