A clinicoetiological analysis of patients with Stevens–Johnson syndrome and toxic epidermal necrolysis treated at Sohag University Hospital, Egypt

Abstract

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are characterized by widespread epidermal necrosis and mucosal involvement secondary to keratinocyte apoptosis induced mostly by drugs and associated with high mortality. To examine the prevalence, etiology, clinical presentations, and outcome of SJS/TEN in patients admitted in the Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt. This observational study included all patients with SJS/TEN admitted in the Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt, between September 2013 and September 2014. All patients with SJS/TEN were subjected to complete medical history and examinations to evaluate the extent of skin and mucous membrane involvement, complications, and other system affections. They also underwent complete laboratory investigations. The severity-of-illness score for toxic epidermal necrolysis was used to evaluate all patients within the first 24 h of admission. Of the 500 patients admitted, 21 (4.2%) were diagnosed with SJS/TEN (six men and 15 women; mean age 30.4 years). Fourteen patients were diagnosed with SJS (n=14; 66.7%), three with SJS/TEN overlap (n=3; 14.3%), and four with TEN (n=4; 19%). Nineteen patients (90.5%) had a history of drug intake. The most common causative drugs were carbamazepine (33.3%) and antibiotics+NSAIDs (28.57%). The main limitations of our study were the small sample size. SJS and TEN are uncommon diseases. Most of the cases of SJS/TEN were drug-induced. The most common offending drugs were carbamazepine, NSAIDs, and antibiotics.