Aspects pharmaco-cliniques, thérapeutiques et évolutifs du spectre Stevens-Johnson et Lyell (série de 27 cas)

Abstract

IntroductionStevens Johnson syndrome and Lyell syndrome are rare and potentially serious drug hypersensitivity reactions. The aim of this work is to describe the epidemiological, pharmacological, clinical, therapeutic and evolutionary aspects of the SSJ-SL spectrum. MethodsThis is a retrospective analytical study from 2011 to 2021 of data from patients hospitalized at the dermatology department of CHU Ibn Rochd. ResultsTwenty-seven cases were identified (18 of SSJ 7 of SL and 2 SC). The average age was 47years, with a female predominance (74%). The incriminating drugs were allopurinol in 37% of cases, NSAIDs and antibiotics (18% each). The average delay was 21days. All our patients had oral mucosal involvement, 74% had conjunctival involvement. 29% had hepatic cytolysis. 29% had hypoprotidemia, 18% had functional renal failure. Management consisted of immediate cessation of all medications, a double antihistamine, local skin and mucous membrane care, and correction of electrolyte disorders. The main complications were: transition to the Lyell form in 3 SSJ patients, dysphagia in 5 patients, pneumonia in 4 patients. With a mortality rate of 15%. ConclusionIn Morocco, the spectrum of SSJ- SL presents the same characteristics as the data of other series in the world: rarity, severity, predominance of adult age and female sex. Allopurinol is the most frequent cause, hence the need to rationalize the prescription of this drug.