Stevens-Johnson syndrome and toxic epidermal necrolysis cases treated at our hospital over the past 10 years

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute inflammatory diseases of the skin and mucous membranes such as the ocular surface. This study aimed to evaluate the backgrounds, clinical symptoms, and disease course of SJS/TEN patients in our hospital. We retrospectively collected the data of the medical history, clinical symptoms, examinations, and treatments in patients with SJS or TEN, which were diagnosed in the Department of Dermatology, Kyoto Prefectural University of Medicine Hospital between April 2007 and March 2017. The subjects were 15 patients with SJS and five with TEN. All five children had cold symptoms and took cold medications. On the other hand, 15 adult patients took various types of drugs, such as antibiotics, cold medications, or anticonvulsants. Interestingly, all pediatric patients did not have large skin lesions but suffered from severe eye symptoms, while the severity of their skin and mucous lesions was various in adult patients. All patients were treated with oral corticosteroid therapy. Furthermore, 18 patients were treated with corticosteroid pulse therapy, six with high-dose immunoglobulin therapy, and one with plasmapheresis. Our findings imply that cold symptoms and cold medicines may be associated with severe ocular involvement in SJS/TEN patients.