Retrospective analysis of twenty-four cases of Stevens-Johnson syndrome or toxic epidermal necrolysis

Abstract

Objective To analyze the clinical characteristics of the ocular symptoms and treatment for Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) induced by using drugs. Methods A retrospective analysis was undertaken of all patients admitted between May 2012 and February 2014 in Peking Union Medical College Hospital with a diagnosis of SJS or TEN. Results A total of 24 patients with SJS or TEN were consecutively recruited. Of the 24 patients, antibiotics (7 patients) , antipyretic analgesics (6 patients) and antipsychotics (4 patients) were the main drugs causing ocular symptoms. Ocular involvement was noted in 16 patients. Of the 16 patients with ocular involvement, all of them had bilateral lesions. Conjunctival hyperaemia, conjunctival exudation and eyelid lesion were noted in 13 patients, 12 patients and 9 patients, respectively. Conjunctival pseudomembrane, lid margin lesion, and corneal erosion were noted in 7 patients, 7 patients and 3 patients, respectively. Systemic corticosteriod was administered in all cases. Ophthalmic treatments were also used on patients with ocular involvement, including corticosteriod eyedrops, cyclosporin eyedrops, artificial tears or separation of symblepharon. Treatment was based on the severity of the ocular symptoms. Conclusion SJS and TEN exhibit variable degrees of skin and mucous membrane damage within the acute stage, commonly accompanied with ocular involvement. Sufficient systemic and local corticosteriod are essential to control disease progression and reduce ocular complications. Key words: Stevens-Johnson syndrome; Toxic epidermal necrolysis; Drug eruption; Retrospective study