Abstract
BackgroundStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening conditions that initially affect the skin and mucous membranes. The aim of this study was to compare the acute ocular manifestations between SJS and TEN.MethodsThe initial presenting ophthalmic records of patients with either SJS (<30% body surface area involvement) or TEN (> = 30% involvement), who were treated at one tertiary burn center in Hong Kong between 1999 and 2014, were retrospectively analyzed and compared.ResultsA total of 20 SJS and 12 TEN cases were included. All were drug-induced. The patient demographics and treatment received were comparable. Overall, 40% of SJS and 75% of TEN patients had acute ocular surface inflammation. When comparing the two groups, there was a significant difference in the number of cases with mild involvement (5% in SJS, 42% in TEN, p = 0.01), while no statistically significant differences were found (p > 0.05) comparing between the moderate (15% in SJS, 0% in TEN) and severe groups (20% in SJS, 33% in TEN).ConclusionsOcular surface inflammation was common during the acute phase in both SJS and TEN. TEN had a significantly higher number of cases with mild ocular involvement when compared with SJS, but no significant difference between the number of moderate and severe cases between the two groups.
Highlights
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening conditions that initially affect the skin and mucous membranes
Since 1993 they have been differentiated by total body surface area (BSA) of involvement, with SJS representing the mild end of the spectrum ( = 30% involvement) and SJS/ TEN overlap in cases with 10 to 30% involvement [1,2,3]
During the 15-years study period, a total of 56 inpatients were diagnosed with SJS or SJS/TEN overlap (39 cases) or TEN (17 case). 24 patients (19 SJS or SJS/ TEN overlap and 5 TEN) were excluded due to the lack of available ophthalmic assessment charts
Summary
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening conditions that initially affect the skin and mucous membranes. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute exfoliating diseases of the skin and mucosa and represent different ends of the spectrum of the same clinical entity of severe cutaneous adverse reactions. Ophthalmic involvement is common in patients with SJS and TEN, and the acute ocular involvement is reported to occur in 50 to 88% of cases [6, 7]. Acute ocular surface inflammation results in devastating long-term sequelae, including dry eye disease, recurrent or persistent corneal epithelial defects, conjunctival scarring, symblephera formation, cornea limbal stem cell deficiency and corneal scarring [6, 8,9,10,11,12].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call