Lacrimal passage irrigation in children with Stevens-Johnson syndrome or toxic epidermal necrolysis: a five-year retrospective study

Qin Xiang,Lianhong Pi,Jing Fang,Xinke Chen,Xu Gao,Lin Chen,Qing Liu

doi:10.1186/s12886-018-1014-9

Abstract

BackgroundTo identity the effect of lacrimal system irrigation in the acute stage in children with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).MethodsA retrospective review of 39 patients with SJS or TEN from 2012 to 2017 was analyzed. Patients were divided into two subgroups according to whether they received irrigation in the acute stage. The irrigation group included 21 inpatients and the control group included 18 inpatients. The χ2 test was used to compare clinical findings and data in both groups.ResultsThe rate of lacrimal system obstructions in the chronic stage of SJS or TEN in the irrigation group was significantly lower than in the control group (p < 0.01). A significant difference was also found between the epiphora rates in patients with SJS or TEN in the chronic stage in the two groups (p = 0.047). One of 15 patients with mild dry eyes or without dry eyes in the irrigation group had epiphora, and it affected five of 12 in the control group. The difference between the two groups was significant (p = 0.03). Epiphora in the two patients in the control group was long-term, owing to the disappearance of puncta marks.ConclusionsLacrimal system irrigation with dexamethasone drops in the acute stage was a simple way to lessen lacrimal system obstructions and epiphora in patients with SJS or TEN. It should be considered a conventional ocular treatment for SJS or TEN.

Highlights

To identity the effect of lacrimal system irrigation in the acute stage in children with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
Because some children with SJS or TEN exhibited epiphora in the chronic stage in our clinical practice, we aimed to identify the effect of irrigation of the lacrimal system in the acute stage of SJS or TEN in Chinese children
37 patients (20 in the irrigation group and 17 in the control group) had a clear history of drug use, including antibacterial drugs, anticonvulsants, and NonSteroidal Anti-inflammatory Drugs (NSAID), and the other two cases were caused by a viral infection

Summary

Introduction

To identity the effect of lacrimal system irrigation in the acute stage in children with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Stevens-Johnson syndrome (SJS) and its more severe variant, toxic epidermal necrolysis (TEN), are acute blistering diseases of the skin and mucus membranes. They were first reported in 1922 [1] and 1956 [2], respectively. With the severe impact of most ocular complications of SJS or TEN, including dry eye and cicatricial ocular blinding, on the quality of patients’ lives in the recovery period of the disease, more light must be shed on the timely ocular treatment of patients with SJS or TEN. With a further understanding of the disease and timely ocular treatments, dry eyes would be alleviated in patients with SJS or TEN, lessening the influence of tear secretions

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